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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | None | $61.66 | $61.66 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $117.49 Typical High $323.59 | Facility | None | $107.15 | $117.49 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $134.90 | Professional | None | $48.98 | $60.26 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Denver HMP Setting Facility Modifier None Typical Low $33.11 Median $61.66 Typical High $141.25 | Facility | None | $33.11 | $61.66 | $141.25 |
Denver HMP Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $223.87 | Professional | None | $83.18 | $144.54 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $208.93 Typical High $234.42 | Facility | None | $112.20 | $208.93 | $234.42 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $141.25 | Professional | None | $81.28 | $112.20 | $141.25 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $60.26 | Facility | None | $50.12 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $77.62 | Professional | None | $46.77 | $51.29 | $77.62 |
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 $30.90 Median $30.90 Typical High $35.48 | Professional | 52 · Reduced service | $30.90 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $14.13 | Professional | 53 · Discontinued | $12.30 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $10.72 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $7.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $60.26 Typical High $60.26 | Professional | RR · Rental | $6.03 | $60.26 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Where Colorado sits
The same service costs 2.8 times more in Wisconsin 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· 36th of 51
$61.66
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.