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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | None | $199.53 | $199.53 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $380.19 Typical High $1,047.13 | Facility | None | $346.74 | $380.19 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $467.74 | Professional | None | $141.25 | $218.78 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Denver HMP Setting Facility Modifier None Typical Low $114.82 Median $199.53 Typical High $436.52 | Facility | None | $114.82 | $199.53 | $436.52 |
Denver HMP Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $691.83 | Professional | None | $263.03 | $467.74 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $676.08 Typical High $758.58 | Facility | None | $363.08 | $676.08 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $478.63 | Professional | None | $251.19 | $363.08 | $478.63 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Facility | None | $199.53 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $269.15 | Professional | None | $158.49 | $177.83 | $269.15 |
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 $100.00 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $100.00 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | 53 · Discontinued | $39.81 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $218.78 Typical High $218.78 | Professional | RR · Rental | $21.88 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | UE · Used equipment | $162.18 | $162.18 | $162.18 |
Where Colorado sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 40th of 51
$200
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.