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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | None | $138.04 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $741.31 | Facility | None | $245.47 | $269.15 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $302.00 | Professional | None | $91.20 | $138.04 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Denver HMP Setting Facility Modifier None Typical Low $74.13 Median $144.54 Typical High $316.23 | Facility | None | $74.13 | $144.54 | $316.23 |
Denver HMP Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $489.78 | Professional | None | $186.21 | $331.13 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $478.63 Typical High $537.03 | Facility | None | $257.04 | $478.63 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $323.59 | Professional | None | $177.83 | $257.04 | $323.59 |
United Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $213.80 | Facility | None | $154.88 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $173.78 | Professional | None | $104.71 | $114.82 | $173.78 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $138.04 Typical High $138.04 | Professional | RR · Rental | $13.80 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | UE · Used equipment | $102.33 | $102.33 | $102.33 |
Where Colorado sits
The same service costs 4.4 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· 34th of 51
$141
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.