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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | None | $112.20 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $229.09 Typical High $616.60 | Facility | None | $208.93 | $229.09 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $275.42 | Professional | None | $83.18 | $114.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
Denver HMP Setting Facility Modifier None Typical Low $60.26 Median $117.49 Typical High $257.04 | Facility | None | $60.26 | $117.49 | $257.04 |
Denver HMP Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $407.38 | Professional | None | $158.49 | $281.84 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $398.11 Typical High $457.09 | Facility | None | $213.80 | $398.11 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $269.15 | Professional | None | $151.36 | $213.80 | $269.15 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $309.03 | Facility | None | $102.33 | $102.33 | $309.03 |
United Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $141.25 | Professional | None | $85.11 | $93.33 | $141.25 |
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 $57.54 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $22.91 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $16.98 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.48 | $11.75 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $114.82 Typical High $134.90 | Professional | RR · Rental | $11.48 | $114.82 | $134.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | UE · Used equipment | $85.11 | $85.11 | $85.11 |
Where Colorado sits
The same service costs 5.4 times more in Kansas 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· 29th of 51
$117
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.