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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | None | $50.12 | $50.12 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $263.03 | Facility | None | $87.10 | $97.72 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $54.95 Typical High $123.03 | Professional | None | $35.48 | $54.95 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Denver HMP Setting Facility Modifier None Typical Low $28.84 Median $54.95 Typical High $114.82 | Facility | None | $28.84 | $54.95 | $114.82 |
Denver HMP Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $120.23 Typical High $181.97 | Professional | None | $69.18 | $120.23 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $169.82 Typical High $190.55 | Facility | None | $91.20 | $169.82 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $114.82 | Professional | None | $72.44 | $91.20 | $114.82 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $51.29 | Facility | None | $43.65 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $67.61 | Professional | None | $40.74 | $44.67 | $67.61 |
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 $25.12 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $25.12 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $8.13 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $54.95 Typical High $57.54 | Professional | RR · Rental | $7.08 | $54.95 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Where Colorado sits
The same service costs 2.6 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· 48th of 51
$50.12
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.