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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $36.31 | Professional | None | $34.67 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $69.18 Typical High $190.55 | Facility | None | $63.10 | $69.18 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $34.67 Typical High $77.62 | Professional | None | $24.55 | $34.67 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Denver HMP Setting Facility Modifier None Typical Low $18.62 Median $36.31 Typical High $79.43 | Facility | None | $18.62 | $36.31 | $79.43 |
Denver HMP Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $131.83 | Professional | None | $50.12 | $85.11 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $138.04 | Facility | None | $66.07 | $123.03 | $138.04 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $83.18 | Professional | None | $51.29 | $66.07 | $83.18 |
United Setting Facility Modifier None Typical Low $35.48 Median $38.02 Typical High $38.02 | Facility | None | $35.48 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $43.65 | Professional | None | $26.30 | $28.84 | $43.65 |
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 $17.38 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $17.38 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.08 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.25 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.47 | $3.63 | $3.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $34.67 Typical High $34.67 | Professional | RR · Rental | $3.47 | $34.67 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | UE · Used equipment | $26.30 | $26.30 | $26.30 |
Where Colorado sits
The same service costs 3.0 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· 31st of 51
$36.31
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.