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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $39.81 | Professional | None | $30.90 | $39.81 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $208.93 | Facility | None | $69.18 | $81.28 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $32.36 Typical High $70.79 | Professional | None | $21.38 | $32.36 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Denver HMP Setting Facility Modifier None Typical Low $17.38 Median $39.81 Typical High $81.28 | Facility | None | $17.38 | $39.81 | $81.28 |
Denver HMP Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $144.54 | Professional | None | $54.95 | $95.50 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $134.90 Typical High $151.36 | Facility | None | $72.44 | $134.90 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $102.33 | Professional | None | $58.88 | $72.44 | $102.33 |
United Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $51.29 | Facility | None | $35.48 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $39.81 | Professional | None | $23.99 | $26.92 | $39.81 |
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 $16.22 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $16.22 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.46 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $4.79 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.24 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $33.11 Typical High $33.11 | Professional | RR · Rental | $3.24 | $33.11 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | UE · Used equipment | $23.99 | $23.99 | $23.99 |
Where Colorado sits
The same service costs 4.7 times more in Hawaii than in Florida. 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
$38.90
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.