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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | None | $97.72 | $97.72 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $190.55 Typical High $512.86 | Facility | None | $173.78 | $190.55 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $263.03 | Professional | None | $77.62 | $107.15 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Denver HMP Setting Facility Modifier None Typical Low $56.23 Median $107.15 Typical High $223.87 | Facility | None | $56.23 | $107.15 | $223.87 |
Denver HMP Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $346.74 | Professional | None | $134.90 | $234.42 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $331.13 Typical High $380.19 | Facility | None | $181.97 | $331.13 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $251.19 | Professional | None | $158.49 | $181.97 | $251.19 |
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 $79.43 Median $87.10 Typical High $131.83 | Professional | None | $79.43 | $87.10 | $131.83 |
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 $48.98 Median $48.98 Typical High $54.95 | Professional | 52 · Reduced service | $48.98 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | 53 · Discontinued | $19.95 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $16.22 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $107.15 Typical High $107.15 | Professional | RR · Rental | $10.72 | $107.15 | $107.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | UE · Used equipment | $79.43 | $79.43 | $79.43 |
Where Colorado sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 44th of 51
$97.72
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.