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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $67.61 | Professional | None | $52.48 | $67.61 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $128.82 Typical High $346.74 | Facility | None | $117.49 | $128.82 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $131.83 | Professional | None | $38.90 | $54.95 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Denver HMP Setting Facility Modifier None Typical Low $29.51 Median $67.61 Typical High $134.90 | Facility | None | $29.51 | $67.61 | $134.90 |
Denver HMP Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $245.47 | Professional | None | $91.20 | $158.49 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $223.87 Typical High $257.04 | Facility | None | $123.03 | $223.87 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $151.36 | Professional | None | $85.11 | $123.03 | $151.36 |
United Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $63.10 | Facility | None | $61.66 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $69.18 | Professional | None | $41.69 | $45.71 | $69.18 |
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 $26.30 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $26.30 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $10.47 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $7.94 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.25 | $6.76 | $6.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $57.54 Typical High $77.62 | Professional | RR · Rental | $5.50 | $57.54 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | UE · Used equipment | $41.69 | $41.69 | $41.69 |
Where Colorado sits
The same service costs 4.3 times more in Hawaii 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· 21st of 51
$63.10
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.