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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $186.21 | Professional | None | $154.88 | $162.18 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $316.23 Typical High $851.14 | Facility | None | $281.84 | $316.23 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $229.09 | Professional | None | $120.23 | $147.91 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Facility | None | $177.83 | $177.83 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $190.55 | Professional | None | $128.82 | $128.82 | $190.55 |
Denver HMP Setting Facility Modifier None Typical Low $85.11 Median $165.96 Typical High $371.54 | Facility | None | $85.11 | $165.96 | $371.54 |
Denver HMP Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $389.05 Typical High $562.34 | Professional | None | $218.78 | $389.05 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $549.54 Typical High $616.60 | Facility | None | $295.12 | $549.54 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $371.54 | Professional | None | $208.93 | $295.12 | $371.54 |
United Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $186.21 | Facility | None | $177.83 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $199.53 | Professional | None | $120.23 | $131.83 | $199.53 |
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 $81.28 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $128.82 Typical High $186.21 | Professional | RR · Rental | $16.22 | $128.82 | $186.21 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $120.23 | Professional | UE · Used equipment | $93.33 | $93.33 | $120.23 |
Where Colorado sits
The same service costs 3.5 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
$162
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.