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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $229.09 | Professional | None | $208.93 | $213.80 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $407.38 Typical High $1,122.02 | Facility | None | $371.54 | $407.38 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $501.19 | Professional | None | $151.36 | $223.87 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Denver HMP Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $467.74 | Facility | None | $123.03 | $213.80 | $467.74 |
Denver HMP Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $741.31 | Professional | None | $281.84 | $501.19 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $707.95 Typical High $812.83 | Facility | None | $389.05 | $707.95 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $512.86 | Professional | None | $302.00 | $389.05 | $512.86 |
United Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $380.19 | Facility | None | $251.19 | $380.19 | $380.19 |
United Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $281.84 | Professional | None | $169.82 | $190.55 | $281.84 |
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 $107.15 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $22.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.39 Median $223.87 Typical High $223.87 | Professional | RR · Rental | $22.39 | $223.87 | $223.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Where Colorado sits
The same service costs 5.5 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· 42nd of 51
$214
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.