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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $97.72 | Professional | None | $85.11 | $93.33 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $181.97 Typical High $489.78 | Facility | None | $165.96 | $181.97 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $194.98 | Professional | None | $58.88 | $87.10 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Denver HMP Setting Facility Modifier None Typical Low $45.71 Median $93.33 Typical High $213.80 | Facility | None | $45.71 | $93.33 | $213.80 |
Denver HMP Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $338.84 | Professional | None | $128.82 | $223.87 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $316.23 Typical High $363.08 | Facility | None | $169.82 | $316.23 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $239.88 | Professional | None | $120.23 | $169.82 | $239.88 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $229.09 | Facility | None | $87.10 | $87.10 | $229.09 |
United Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $107.15 | Professional | None | $63.10 | $70.79 | $107.15 |
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 $44.67 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.20 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $13.49 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $9.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $87.10 Typical High $87.10 | Professional | RR · Rental | $8.51 | $87.10 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $63.10 |
Where Colorado sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 26th of 51
$93.33
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.