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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | None | $91.20 | $112.20 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $588.84 | Facility | None | $194.98 | $218.78 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $199.53 | Professional | None | $63.10 | $91.20 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Denver HMP Setting Facility Modifier None Typical Low $48.98 Median $112.20 Typical High $229.09 | Facility | None | $48.98 | $112.20 | $229.09 |
Denver HMP Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $389.05 | Professional | None | $154.88 | $263.03 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $380.19 Typical High $426.58 | Facility | None | $204.17 | $380.19 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $288.40 | Professional | None | $144.54 | $204.17 | $288.40 |
United Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $100.00 | Facility | None | $95.50 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $112.20 | Professional | None | $67.61 | $75.86 | $112.20 |
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 $45.71 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $45.71 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.12 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $93.33 Typical High $93.33 | Professional | RR · Rental | $9.12 | $93.33 | $93.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | UE · Used equipment | $69.18 | $69.18 | $69.18 |
Where Colorado sits
The same service costs 3.2 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· 22nd of 51
$100
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.