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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | None | $104.71 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $251.19 Typical High $691.83 | Facility | None | $229.09 | $251.19 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $234.42 | Professional | None | $69.18 | $107.15 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Denver HMP Setting Facility Modifier None Typical Low $56.23 Median $131.83 Typical High $263.03 | Facility | None | $56.23 | $131.83 | $263.03 |
Denver HMP Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $309.03 Typical High $457.09 | Professional | None | $173.78 | $309.03 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $446.68 Typical High $501.19 | Facility | None | $239.88 | $446.68 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $302.00 | Professional | None | $165.96 | $239.88 | $302.00 |
United Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $107.15 | Facility | None | $89.13 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $131.83 | Professional | None | $79.43 | $87.10 | $131.83 |
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 $52.48 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $21.38 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $15.85 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $13.18 | $13.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $107.15 Typical High $107.15 | Professional | RR · Rental | $10.72 | $107.15 | $107.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $81.28 | $81.28 | $81.28 |
Where Colorado sits
The same service costs 3.0 times more in Montana 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· 27th of 51
$110
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.