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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $199.53 | Professional | None | $181.97 | $186.21 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $354.81 Typical High $977.24 | Facility | None | $323.59 | $354.81 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $446.68 | Professional | None | $134.90 | $186.21 | $446.68 |
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 $97.72 Median $186.21 Typical High $398.11 | Facility | None | $97.72 | $186.21 | $398.11 |
Denver HMP Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $645.65 | Professional | None | $245.47 | $436.52 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $707.95 | Facility | None | $338.84 | $630.96 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $426.58 | Professional | None | $234.42 | $338.84 | $426.58 |
United Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $173.78 | Facility | None | $125.89 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $229.09 | Professional | None | $138.04 | $151.36 | $229.09 |
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 $91.20 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $36.31 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $26.92 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.20 | $18.62 | $18.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $186.21 Typical High $213.80 | Professional | RR · Rental | $18.62 | $186.21 | $213.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | UE · Used equipment | $138.04 | $138.04 | $138.04 |
Where Colorado sits
The same service costs 2.7 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· 34th of 51
$186
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.