How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | None | $102.33 | $102.33 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $199.53 Typical High $537.03 | Facility | None | $181.97 | $199.53 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $323.59 | Professional | None | $72.44 | $112.20 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Denver HMP Setting Facility Modifier None Typical Low $58.88 Median $102.33 Typical High $223.87 | Facility | None | $58.88 | $102.33 | $223.87 |
Denver HMP Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $354.81 | Professional | None | $141.25 | $245.47 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $346.74 Typical High $398.11 | Facility | None | $186.21 | $346.74 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $234.42 | Professional | None | $147.91 | $186.21 | $234.42 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $100.00 | Facility | None | $87.10 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $138.04 | Professional | None | $83.18 | $91.20 | $138.04 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | 52 · Reduced service | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $23.44 | Professional | 53 · Discontinued | $20.42 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $112.20 Typical High $112.20 | Professional | RR · Rental | $11.22 | $112.20 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | UE · Used equipment | $83.18 | $83.18 | $83.18 |
Where Colorado sits
The same service costs 2.4 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Colorado· 45th of 51
$102
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.