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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | None | $67.61 | $67.61 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $131.83 Typical High $354.81 | Facility | None | $120.23 | $131.83 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $186.21 | Professional | None | $51.29 | $75.86 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $100.00 | Professional | None | $56.23 | $56.23 | $100.00 |
Denver HMP Setting Facility Modifier None Typical Low $38.90 Median $67.61 Typical High $154.88 | Facility | None | $38.90 | $67.61 | $154.88 |
Denver HMP Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $245.47 | Professional | None | $93.33 | $162.18 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $229.09 Typical High $263.03 | Facility | None | $123.03 | $229.09 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $165.96 | Professional | None | $87.10 | $123.03 | $165.96 |
United Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $81.28 | Facility | None | $60.26 | $81.28 | $81.28 |
United Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $91.20 | Professional | None | $54.95 | $60.26 | $91.20 |
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 $33.88 Median $33.88 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $15.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $11.48 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $75.86 Typical High $75.86 | Professional | RR · Rental | $7.41 | $75.86 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | UE · Used equipment | $54.95 | $54.95 | $54.95 |
Where Colorado sits
The same service costs 3.1 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· 48th of 51
$67.61
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.