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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | None | $154.88 | $165.96 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $316.23 Typical High $870.96 | Facility | None | $288.40 | $316.23 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $363.08 | Professional | None | $117.49 | $162.18 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Denver HMP Setting Facility Modifier None Typical Low $83.18 Median $165.96 Typical High $338.84 | Facility | None | $83.18 | $165.96 | $338.84 |
Denver HMP Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $389.05 Typical High $575.44 | Professional | None | $218.78 | $389.05 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $549.54 Typical High $630.96 | Facility | None | $302.00 | $549.54 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $371.54 | Professional | None | $208.93 | $302.00 | $371.54 |
United Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $151.36 | Facility | None | $147.91 | $151.36 | $151.36 |
United Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $194.98 | Professional | None | $117.49 | $128.82 | $194.98 |
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 $77.62 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $77.62 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $31.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $23.44 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $15.49 | $16.60 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $162.18 Typical High $162.18 | Professional | RR · Rental | $15.85 | $162.18 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Where Colorado sits
The same service costs 2.3 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· 27th of 51
$166
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.