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 $50.12 Median $50.12 Typical High $128.82 | Facility | None | $50.12 | $50.12 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $54.95 | Professional | None | $43.65 | $50.12 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $263.03 | Facility | None | $87.10 | $97.72 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $117.49 | Professional | None | $35.48 | $47.86 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Denver HMP Setting Facility Modifier None Typical Low $25.70 Median $50.12 Typical High $107.15 | Facility | None | $25.70 | $50.12 | $107.15 |
Denver HMP Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $120.23 Typical High $181.97 | Professional | None | $69.18 | $120.23 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $169.82 Typical High $190.55 | Facility | None | $91.20 | $169.82 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $128.82 | Professional | None | $64.57 | $91.20 | $128.82 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $60.26 | Professional | None | $35.48 | $39.81 | $60.26 |
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 $24.55 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $24.55 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $9.77 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.24 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.90 | $5.01 | $5.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $47.86 Typical High $47.86 | Professional | RR · Rental | $4.68 | $47.86 | $47.86 |
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 3.0 times more in Hawaii than in Kansas. 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
$50.12
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.