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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | None | $123.03 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $275.42 Typical High $758.58 | Facility | None | $251.19 | $275.42 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $295.12 | Professional | None | $89.13 | $134.90 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $144.54 Typical High $288.40 | Facility | None | $72.44 | $144.54 | $288.40 |
Denver HMP Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $501.19 | Professional | None | $190.55 | $338.84 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $549.54 | Facility | None | $263.03 | $489.78 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $331.13 | Professional | None | $186.21 | $263.03 | $331.13 |
United Setting Facility Modifier None Typical Low $151.36 Median $371.54 Typical High $389.05 | Facility | None | $151.36 | $371.54 | $389.05 |
United Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $169.82 | Professional | None | $102.33 | $112.20 | $169.82 |
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 $66.07 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $66.07 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $26.30 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $19.50 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.18 | $14.45 | $14.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $134.90 Typical High $134.90 | Professional | RR · Rental | $13.49 | $134.90 | $134.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | UE · Used equipment | $100.00 | $100.00 | $100.00 |
Where Colorado sits
The same service costs 8.1 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· 22nd of 51
$145
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.