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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | None | $169.82 | $169.82 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $295.12 Median $331.13 Typical High $891.25 | Facility | None | $295.12 | $331.13 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $398.11 | Professional | None | $120.23 | $181.97 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Denver HMP Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $371.54 | Facility | None | $97.72 | $169.82 | $371.54 |
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 $229.09 Median $407.38 Typical High $588.84 | Professional | None | $229.09 | $407.38 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $575.44 Typical High $645.65 | Facility | None | $309.03 | $575.44 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $407.38 | Professional | None | $251.19 | $309.03 | $407.38 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $204.17 | Facility | None | $199.53 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $223.87 | Professional | None | $134.90 | $151.36 | $223.87 |
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 $85.11 Median $85.11 Typical High $91.20 | Professional | 52 · Reduced service | $85.11 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $36.31 | Professional | 53 · Discontinued | $33.88 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $181.97 Typical High $194.98 | Professional | RR · Rental | $18.20 | $181.97 | $194.98 |
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 3.3 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· 42nd of 51
$170
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.