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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | None | $162.18 | $162.18 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $309.03 Typical High $831.76 | Facility | None | $281.84 | $309.03 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $363.08 | Professional | None | $112.20 | $162.18 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Denver HMP Setting Facility Modifier None Typical Low $89.13 Median $165.96 Typical High $363.08 | Facility | None | $89.13 | $165.96 | $363.08 |
Denver HMP Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $549.54 | Professional | None | $213.80 | $380.19 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $537.03 Typical High $616.60 | Facility | None | $295.12 | $537.03 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $371.54 | Professional | None | $213.80 | $295.12 | $371.54 |
United Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $229.09 | Facility | None | $181.97 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $204.17 | Professional | None | $123.03 | $138.04 | $204.17 |
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 $79.43 Median $79.43 Typical High $83.18 | Professional | 52 · Reduced service | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | 53 · Discontinued | $32.36 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $162.18 Typical High $162.18 | Professional | RR · Rental | $16.22 | $162.18 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | UE · Used equipment | $123.03 | $123.03 | $123.03 |
Where Colorado sits
The same service costs 4.7 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· 34th of 51
$162
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.