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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | None | $85.11 | $85.11 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $162.18 Typical High $446.68 | Facility | None | $147.91 | $162.18 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $213.80 | Professional | None | $74.13 | $97.72 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $125.89 | Professional | None | $85.11 | $85.11 | $125.89 |
Denver HMP Setting Facility Modifier None Typical Low $48.98 Median $85.11 Typical High $190.55 | Facility | None | $48.98 | $85.11 | $190.55 |
Denver HMP Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $309.03 | Professional | None | $114.82 | $199.53 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $281.84 Typical High $323.59 | Facility | None | $154.88 | $281.84 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $190.55 | Professional | None | $107.15 | $154.88 | $190.55 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $112.20 | Professional | None | $67.61 | $75.86 | $112.20 |
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 $42.66 Median $42.66 Typical High $47.86 | Professional | 52 · Reduced service | $42.66 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $19.05 | Professional | 53 · Discontinued | $16.98 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $97.72 Typical High $97.72 | Professional | RR · Rental | $9.33 | $97.72 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | UE · Used equipment | $70.79 | $70.79 | $70.79 |
Where Colorado sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 51st of 51
$85.11
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.