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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | None | $114.82 | $114.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $223.87 Typical High $602.56 | Facility | None | $199.53 | $223.87 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $426.58 | Professional | None | $134.90 | $199.53 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Denver HMP Setting Facility Modifier None Typical Low $104.71 Median $151.36 Typical High $323.59 | Facility | None | $104.71 | $151.36 | $323.59 |
Denver HMP Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $416.87 | Professional | None | $154.88 | $275.42 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $436.52 | Facility | None | $208.93 | $389.05 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $346.74 | Professional | None | $218.78 | $295.12 | $346.74 |
United Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $234.42 | Facility | None | $213.80 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $245.47 | Professional | None | $138.04 | $162.18 | $245.47 |
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 $57.54 Median $57.54 Typical High $85.11 | Professional | 52 · Reduced service | $57.54 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $33.88 | Professional | 53 · Discontinued | $22.91 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $25.70 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $204.17 Typical High $239.88 | Professional | RR · Rental | $19.95 | $204.17 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | UE · Used equipment | $147.91 | $147.91 | $147.91 |
Where Colorado sits
The same service costs 2.9 times more in Hawaii than in Utah. 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
$162
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.