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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | None | $302.00 | $309.03 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $588.84 Typical High $1,621.81 | Facility | None | $537.03 | $588.84 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $707.95 | Professional | None | $208.93 | $302.00 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $676.08 | Facility | None | $158.49 | $309.03 | $676.08 |
Denver HMP Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $1,071.52 | Professional | None | $389.05 | $724.44 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,174.90 | Facility | None | $562.34 | $1,047.13 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $776.25 | Professional | None | $436.52 | $562.34 | $776.25 |
United Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $426.58 | Facility | None | $331.13 | $426.58 | $426.58 |
United Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $371.54 | Professional | None | $223.87 | $245.47 | $371.54 |
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 $151.36 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $60.26 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.20 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $302.00 Typical High $302.00 | Professional | RR · Rental | $30.20 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | UE · Used equipment | $223.87 | $223.87 | $223.87 |
Where Colorado sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 27th of 51
$309
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.