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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | None | $190.55 | $190.55 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $1,000.00 | Facility | None | $331.13 | $363.08 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $588.84 | Professional | None | $131.83 | $204.17 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $416.87 | Facility | None | $109.65 | $190.55 | $416.87 |
Denver HMP Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $660.69 | Professional | None | $251.19 | $446.68 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $630.96 Typical High $724.44 | Facility | None | $346.74 | $630.96 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $478.63 | Professional | None | $239.88 | $346.74 | $478.63 |
United Setting Facility Modifier None Typical Low $36.31 Median $169.82 Typical High $169.82 | Facility | None | $36.31 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $251.19 | Professional | None | $151.36 | $169.82 | $251.19 |
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 $95.50 Median $95.50 Typical High $109.65 | Professional | 52 · Reduced service | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | 53 · Discontinued | $38.02 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $204.17 Typical High $204.17 | Professional | RR · Rental | $20.42 | $204.17 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | UE · Used equipment | $154.88 | $154.88 | $154.88 |
Where Colorado sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 44th of 51
$191
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.