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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $39.81 | Professional | None | $36.31 | $37.15 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $72.44 Typical High $194.98 | Facility | None | $64.57 | $72.44 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $36.31 Typical High $79.43 | Professional | None | $26.30 | $36.31 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Denver HMP Setting Facility Modifier None Typical Low $19.50 Median $37.15 Typical High $77.62 | Facility | None | $19.50 | $37.15 | $77.62 |
Denver HMP Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $134.90 | Professional | None | $51.29 | $87.10 | $134.90 |
Select Health Setting Facility Modifier None Typical Low $67.61 Median $125.89 Typical High $141.25 | Facility | None | $67.61 | $125.89 | $141.25 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $95.50 | Professional | None | $53.70 | $67.61 | $95.50 |
United Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $52.48 | Facility | None | $40.74 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $45.71 | Professional | None | $27.54 | $30.20 | $45.71 |
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 $18.20 Median $18.62 Typical High $19.05 | Professional | 52 · Reduced service | $18.20 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.59 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.62 Typical High $5.75 | Professional | 55 · Aftercare only | $5.50 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $37.15 Typical High $37.15 | Professional | RR · Rental | $3.63 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | UE · Used equipment | $27.54 | $27.54 | $27.54 |
Where Colorado sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 32nd of 51
$37.15
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.