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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | None | $54.95 | $54.95 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $104.71 Typical High $288.40 | Facility | None | $95.50 | $104.71 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $165.96 | Professional | None | $48.98 | $60.26 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
Denver HMP Setting Facility Modifier None Typical Low $31.62 Median $56.23 Typical High $123.03 | Facility | None | $31.62 | $56.23 | $123.03 |
Denver HMP Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $199.53 | Professional | None | $74.13 | $128.82 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $208.93 | Facility | None | $100.00 | $181.97 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $131.83 | Professional | None | $75.86 | $100.00 | $131.83 |
United Setting Facility Modifier None Typical Low $64.57 Median $72.44 Typical High $72.44 | Facility | None | $64.57 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $72.44 | Professional | None | $43.65 | $48.98 | $72.44 |
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 $27.54 Median $27.54 Typical High $32.36 | Professional | 52 · Reduced service | $27.54 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $12.88 | Professional | 53 · Discontinued | $10.96 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $6.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $60.26 Typical High $60.26 | Professional | RR · Rental | $6.03 | $60.26 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | UE · Used equipment | $44.67 | $44.67 | $44.67 |
Where Colorado sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 29th of 51
$61.66
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.