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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | None | $102.33 | $114.82 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $218.78 Typical High $588.84 | Facility | None | $199.53 | $218.78 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $269.15 | Professional | None | $75.86 | $100.00 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Denver HMP Setting Facility Modifier None Typical Low $54.95 Median $114.82 Typical High $229.09 | Facility | None | $54.95 | $114.82 | $229.09 |
Denver HMP Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $398.11 | Professional | None | $154.88 | $269.15 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $436.52 | Facility | None | $208.93 | $380.19 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $257.04 | Professional | None | $138.04 | $208.93 | $257.04 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $85.11 | Facility | None | $72.44 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $128.82 | Professional | None | $75.86 | $85.11 | $128.82 |
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 $52.48 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $52.48 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $20.89 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $10.00 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | UE · Used equipment | $74.13 | $74.13 | $74.13 |
Where Colorado sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 23rd of 51
$115
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.