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 $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | None | $831.76 | $831.76 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $4,365.16 | Facility | None | $1,445.44 | $1,584.89 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $2,238.72 | Professional | None | $676.08 | $912.01 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
Denver HMP Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $1,905.46 | Facility | None | $478.63 | $851.14 | $1,905.46 |
Denver HMP Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,949.84 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $3,162.28 | Facility | None | $1,513.56 | $2,818.38 | $3,162.28 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,513.56 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,000.00 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,122.02 | Professional | None | $676.08 | $741.31 | $1,122.02 |
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 $416.87 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $912.01 Typical High $912.01 | Professional | RR · Rental | $91.20 | $912.01 | $912.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | UE · Used equipment | $676.08 | $676.08 | $676.08 |
Where Colorado sits
The same service costs 3.9 times more in Hawaii than in West Virginia. 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· 45th of 51
$832
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.