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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | None | $52.48 | $52.48 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $275.42 | Facility | None | $93.33 | $102.33 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $123.03 | Professional | None | $40.74 | $57.54 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Denver HMP Setting Facility Modifier None Typical Low $30.20 Median $52.48 Typical High $120.23 | Facility | None | $30.20 | $52.48 | $120.23 |
Denver HMP Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $199.53 | Professional | None | $72.44 | $125.89 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $177.83 Typical High $199.53 | Facility | None | $95.50 | $177.83 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $128.82 | Professional | None | $67.61 | $95.50 | $128.82 |
United Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $93.33 | Facility | None | $63.10 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $70.79 | Professional | None | $42.66 | $46.77 | $70.79 |
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 $26.30 Typical High $28.84 | Professional | 52 · Reduced service | $26.30 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $11.48 | Professional | 53 · Discontinued | $10.47 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.51 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $57.54 Typical High $57.54 | Professional | RR · Rental | $5.75 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Where Colorado sits
The same service costs 4.4 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· 34th of 51
$58.88
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.