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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $56.23 | Professional | None | $48.98 | $52.48 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $100.00 Typical High $275.42 | Facility | None | $91.20 | $100.00 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $123.03 | Professional | None | $32.36 | $48.98 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Denver HMP Setting Facility Modifier None Typical Low $26.30 Median $52.48 Typical High $112.20 | Facility | None | $26.30 | $52.48 | $112.20 |
Denver HMP Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $194.98 | Professional | None | $70.79 | $123.03 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $173.78 Typical High $199.53 | Facility | None | $95.50 | $173.78 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $131.83 | Professional | None | $66.07 | $95.50 | $131.83 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $61.66 | Professional | None | $37.15 | $40.74 | $61.66 |
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 $25.12 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $25.12 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.00 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.59 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.01 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $48.98 Typical High $60.26 | Professional | RR · Rental | $4.90 | $48.98 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | UE · Used equipment | $37.15 | $37.15 | $37.15 |
Where Colorado sits
The same service costs 2.3 times more in Kansas 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· 32nd of 51
$52.48
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.