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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | None | $42.66 | $42.66 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $81.28 Typical High $223.87 | Facility | None | $74.13 | $81.28 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $107.15 | Professional | None | $30.20 | $47.86 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
Denver HMP Setting Facility Modifier None Typical Low $24.55 Median $42.66 Typical High $97.72 | Facility | None | $24.55 | $42.66 | $97.72 |
Denver HMP Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $154.88 | Professional | None | $58.88 | $100.00 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $144.54 Typical High $162.18 | Facility | None | $77.62 | $144.54 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $109.65 | Professional | None | $67.61 | $77.62 | $109.65 |
United Setting Facility Modifier None Typical Low $47.86 Median $51.29 Typical High $51.29 | Facility | None | $47.86 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $57.54 | Professional | None | $34.67 | $38.02 | $57.54 |
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 $21.38 Median $21.38 Typical High $22.91 | Professional | 52 · Reduced service | $21.38 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $8.51 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.92 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $47.86 Typical High $48.98 | Professional | RR · Rental | $4.79 | $47.86 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | UE · Used equipment | $34.67 | $34.67 | $34.67 |
Where Colorado sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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· 41st of 51
$42.66
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.