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 $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | None | $776.25 | $776.25 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $3,981.07 | Facility | None | $1,348.96 | $1,479.11 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $2,089.30 | Professional | None | $588.84 | $812.83 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
Denver HMP Setting Facility Modifier None Typical Low $446.68 Median $776.25 Typical High $1,737.80 | Facility | None | $446.68 | $776.25 | $1,737.80 |
Denver HMP Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,819.70 Typical High $2,630.27 | Professional | None | $977.24 | $1,819.70 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,570.40 Typical High $2,951.21 | Facility | None | $1,412.54 | $2,570.40 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,412.54 | $1,949.84 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,318.26 | Facility | None | $912.01 | $1,318.26 | $1,318.26 |
United Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,023.29 | Professional | None | $616.60 | $691.83 | $1,023.29 |
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 $380.19 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $812.83 Typical High $812.83 | Professional | RR · Rental | $81.28 | $812.83 | $812.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | UE · Used equipment | $602.56 | $602.56 | $602.56 |
Where Colorado sits
The same service costs 5.1 times more in Hawaii 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· 42nd of 51
$776
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.