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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | None | $257.04 | $275.42 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $537.03 Typical High $1,445.44 | Facility | None | $489.78 | $537.03 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $524.81 | Professional | None | $186.21 | $239.88 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Denver HMP Setting Facility Modifier None Typical Low $125.89 Median $275.42 Typical High $562.34 | Facility | None | $125.89 | $275.42 | $562.34 |
Denver HMP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $954.99 | Professional | None | $354.81 | $630.96 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $933.25 Typical High $1,071.52 | Facility | None | $501.19 | $933.25 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $630.96 | Professional | None | $338.84 | $501.19 | $630.96 |
United Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $204.17 | Facility | None | $147.91 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $295.12 | Professional | None | $177.83 | $194.98 | $295.12 |
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 $125.89 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $239.88 Typical High $316.23 | Professional | RR · Rental | $23.99 | $239.88 | $316.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
Where Colorado sits
The same service costs 2.9 times more in Montana 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· 29th of 51
$245
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.