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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | None | $112.20 | $112.20 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $218.78 Typical High $588.84 | Facility | None | $199.53 | $218.78 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $354.81 | Professional | None | $83.18 | $123.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Denver HMP Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $257.04 | Facility | None | $64.57 | $112.20 | $257.04 |
Denver HMP Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $407.38 | Professional | None | $154.88 | $269.15 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $380.19 Typical High $436.52 | Facility | None | $204.17 | $380.19 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $263.03 | Professional | None | $144.54 | $204.17 | $263.03 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $128.82 | Facility | None | $63.10 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $151.36 | Professional | None | $91.20 | $100.00 | $151.36 |
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 $56.23 Median $56.23 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $25.12 | Professional | 53 · Discontinued | $22.39 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $18.62 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $12.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $123.03 Typical High $123.03 | Professional | RR · Rental | $12.30 | $123.03 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | UE · Used equipment | $91.20 | $91.20 | $91.20 |
Where Colorado sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 43rd of 51
$112
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.