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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $54.95 | Professional | None | $48.98 | $48.98 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $257.04 | Facility | None | $85.11 | $93.33 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $147.91 | Professional | None | $39.81 | $53.70 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Denver HMP Setting Facility Modifier None Typical Low $28.18 Median $48.98 Typical High $107.15 | Facility | None | $28.18 | $48.98 | $107.15 |
Denver HMP Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $181.97 | Professional | None | $66.07 | $114.82 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $165.96 Typical High $186.21 | Facility | None | $89.13 | $165.96 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $125.89 | Professional | None | $79.43 | $89.13 | $125.89 |
United Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $60.26 | Facility | None | $57.54 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $66.07 | Professional | None | $39.81 | $43.65 | $66.07 |
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 $24.55 Median $24.55 Typical High $27.54 | Professional | 52 · Reduced service | $24.55 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.96 | Professional | 53 · Discontinued | $9.77 | $9.77 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $8.32 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $5.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $5.25 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Where Colorado sits
The same service costs 3.5 times more in Hawaii 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· 48th of 51
$48.98
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.