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 $204.17 Median $213.80 Typical High $288.40 | Professional | None | $204.17 | $213.80 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $416.87 Typical High $1,122.02 | Facility | None | $371.54 | $416.87 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $501.19 | Professional | None | $134.90 | $223.87 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $213.80 Typical High $457.09 | Facility | None | $109.65 | $213.80 | $457.09 |
Denver HMP Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $741.31 | Professional | None | $281.84 | $512.86 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $724.44 Typical High $812.83 | Facility | None | $389.05 | $724.44 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $549.54 | Professional | None | $275.42 | $389.05 | $549.54 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $251.19 | Professional | None | $151.36 | $169.82 | $251.19 |
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 $104.71 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $41.69 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $30.90 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.89 | $21.38 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $223.87 Typical High $245.47 | Professional | RR · Rental | $21.88 | $223.87 | $245.47 |
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 2.4 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· 33rd 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.