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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $134.90 Typical High $363.08 | Facility | None | $123.03 | $134.90 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $173.78 | Professional | None | $46.77 | $70.79 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Denver HMP Setting Facility Modifier None Typical Low $37.15 Median $70.79 Typical High $151.36 | Facility | None | $37.15 | $70.79 | $151.36 |
Denver HMP Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $263.03 | Professional | None | $95.50 | $165.96 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $234.42 Typical High $269.15 | Facility | None | $125.89 | $234.42 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $158.49 | Professional | None | $89.13 | $125.89 | $158.49 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $87.10 | Facility | None | $77.62 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $87.10 | Professional | None | $52.48 | $57.54 | $87.10 |
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 $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $13.80 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $70.79 Typical High $70.79 | Professional | RR · Rental | $7.08 | $70.79 | $70.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $52.48 | $52.48 | $52.48 |
Where Colorado sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 41st of 51
$69.18
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.