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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $102.33 | Professional | None | $75.86 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $194.98 Typical High $524.81 | Facility | None | $177.83 | $194.98 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $204.17 | Professional | None | $53.70 | $85.11 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $87.10 Typical High $87.10 | Facility | None | $81.28 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Denver HMP Setting Facility Modifier None Typical Low $43.65 Median $102.33 Typical High $204.17 | Facility | None | $43.65 | $102.33 | $204.17 |
Denver HMP Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $346.74 | Professional | None | $138.04 | $234.42 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $338.84 Typical High $389.05 | Facility | None | $186.21 | $338.84 | $389.05 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $257.04 | Professional | None | $128.82 | $186.21 | $257.04 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $120.23 | Facility | None | $91.20 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $102.33 | Professional | None | $61.66 | $67.61 | $102.33 |
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 $38.90 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $15.85 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $11.75 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $10.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $85.11 Typical High $117.49 | Professional | RR · Rental | $8.13 | $85.11 | $117.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | UE · Used equipment | $61.66 | $61.66 | $61.66 |
Where Colorado sits
The same service costs 5.0 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· 25th of 51
$89.13
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.