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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | None | $57.54 | $57.54 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $109.65 Typical High $302.00 | Facility | None | $100.00 | $109.65 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $60.26 Typical High $154.88 | Professional | None | $40.74 | $60.26 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Denver HMP Setting Facility Modifier None Typical Low $31.62 Median $57.54 Typical High $125.89 | Facility | None | $31.62 | $57.54 | $125.89 |
Denver HMP Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $208.93 | Professional | None | $77.62 | $134.90 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $190.55 Typical High $218.78 | Facility | None | $104.71 | $190.55 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $144.54 | Professional | None | $72.44 | $104.71 | $144.54 |
United Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $48.98 | Facility | None | $29.51 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $74.13 | Professional | None | $44.67 | $48.98 | $74.13 |
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 $28.84 Median $28.84 Typical High $29.51 | Professional | 52 · Reduced service | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.03 |
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 $44.67 Median $44.67 Typical High $44.67 | Professional | UE · Used equipment | $44.67 | $44.67 | $44.67 |
Where Colorado sits
The same service costs 2.4 times more in Montana 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· 42nd of 51
$57.54
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.