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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | None | $151.36 | $151.36 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $288.40 Typical High $794.33 | Facility | None | $263.03 | $288.40 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $346.74 | Professional | None | $120.23 | $154.88 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Denver HMP Setting Facility Modifier None Typical Low $83.18 Median $151.36 Typical High $338.84 | Facility | None | $83.18 | $151.36 | $338.84 |
Denver HMP Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $524.81 | Professional | None | $199.53 | $354.81 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $501.19 Typical High $575.44 | Facility | None | $275.42 | $501.19 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $346.74 | Professional | None | $190.55 | $275.42 | $346.74 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $169.82 | Facility | None | $141.25 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $190.55 | Professional | None | $114.82 | $128.82 | $190.55 |
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 $75.86 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | 53 · Discontinued | $30.20 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $27.54 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $154.88 Typical High $154.88 | Professional | RR · Rental | $15.49 | $154.88 | $154.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Where Colorado sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$151
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.