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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $44.67 | Professional | None | $37.15 | $44.67 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $234.42 | Facility | None | $77.62 | $87.10 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $37.15 Typical High $104.71 | Professional | None | $25.12 | $37.15 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
Denver HMP Setting Facility Modifier None Typical Low $19.95 Median $44.67 Typical High $91.20 | Facility | None | $19.95 | $44.67 | $91.20 |
Denver HMP Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $162.18 | Professional | None | $61.66 | $107.15 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $151.36 Typical High $169.82 | Facility | None | $81.28 | $151.36 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $102.33 | Professional | None | $57.54 | $81.28 | $102.33 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $40.74 | Facility | None | $36.31 | $40.74 | $40.74 |
United Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $46.77 | Professional | None | $28.18 | $30.90 | $46.77 |
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 $18.62 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $18.62 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $5.62 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.72 | $4.47 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.72 Median $37.15 Typical High $37.15 | Professional | RR · Rental | $3.72 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | UE · Used equipment | $27.54 | $27.54 | $27.54 |
Where Colorado sits
The same service costs 2.7 times more in Montana 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· 26th of 51
$40.74
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.