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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $43.65 | Professional | None | $40.74 | $41.69 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $81.28 Typical High $218.78 | Facility | None | $74.13 | $81.28 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $41.69 Typical High $91.20 | Professional | None | $28.84 | $41.69 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Denver HMP Setting Facility Modifier None Typical Low $21.88 Median $41.69 Typical High $95.50 | Facility | None | $21.88 | $41.69 | $95.50 |
Denver HMP Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $154.88 | Professional | None | $57.54 | $100.00 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $141.25 Typical High $162.18 | Facility | None | $75.86 | $141.25 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $107.15 | Professional | None | $53.70 | $75.86 | $107.15 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $109.65 | Facility | None | $38.90 | $38.90 | $109.65 |
United Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $50.12 | Professional | None | $30.20 | $33.88 | $50.12 |
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 $20.89 Median $20.89 Typical High $21.38 | Professional | 52 · Reduced service | $20.89 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.46 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $41.69 Typical High $41.69 | Professional | RR · Rental | $4.07 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | UE · Used equipment | $30.20 | $30.20 | $30.20 |
Where Colorado sits
The same service costs 2.9 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· 28th of 51
$41.69
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.