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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $83.18 | Professional | None | $74.13 | $74.13 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $144.54 Typical High $389.05 | Facility | None | $128.82 | $144.54 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $173.78 | Professional | None | $56.23 | $79.43 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | None | $77.62 | $77.62 | $107.15 |
Denver HMP Setting Facility Modifier None Typical Low $42.66 Median $81.28 Typical High $169.82 | Facility | None | $42.66 | $81.28 | $169.82 |
Denver HMP Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $269.15 | Professional | None | $102.33 | $177.83 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $251.19 Typical High $281.84 | Facility | None | $134.90 | $251.19 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $190.55 | Professional | None | $120.23 | $134.90 | $190.55 |
United Setting Facility Modifier None Typical Low $89.13 Median $218.78 Typical High $870.96 | Facility | None | $89.13 | $218.78 | $870.96 |
United Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $100.00 | Professional | None | $60.26 | $66.07 | $100.00 |
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 $37.15 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $37.15 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $14.79 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $12.59 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.94 Median $81.28 Typical High $81.28 | Professional | RR · Rental | $7.94 | $81.28 | $81.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | UE · Used equipment | $58.88 | $58.88 | $58.88 |
Where Colorado sits
The same service costs 5.1 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· 41st of 51
$77.62
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.