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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $29.51 Typical High $30.90 | Professional | None | $27.54 | $29.51 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $56.23 Typical High $154.88 | Facility | None | $51.29 | $56.23 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $27.54 Typical High $69.18 | Professional | None | $20.42 | $27.54 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Denver HMP Setting Facility Modifier None Typical Low $15.14 Median $29.51 Typical High $63.10 | Facility | None | $15.14 | $29.51 | $63.10 |
Denver HMP Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $107.15 | Professional | None | $40.74 | $69.18 | $107.15 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $112.20 | Facility | None | $53.70 | $100.00 | $112.20 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $75.86 | Professional | None | $38.02 | $53.70 | $75.86 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $34.67 | Professional | None | $20.89 | $23.44 | $34.67 |
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 $14.13 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.13 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.75 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.27 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.82 | $2.95 | $2.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.95 Median $27.54 Typical High $33.88 | Professional | RR · Rental | $2.95 | $27.54 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Where Colorado sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 29th of 51
$29.51
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.