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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | None | $104.71 | $109.65 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $575.44 | Facility | None | $190.55 | $208.93 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $257.04 | Professional | None | $75.86 | $100.00 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Denver HMP Setting Facility Modifier None Typical Low $54.95 Median $109.65 Typical High $234.42 | Facility | None | $54.95 | $109.65 | $234.42 |
Denver HMP Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $380.19 | Professional | None | $147.91 | $257.04 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $371.54 Typical High $416.87 | Facility | None | $199.53 | $371.54 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $281.84 | Professional | None | $138.04 | $199.53 | $281.84 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $128.82 | Professional | None | $77.62 | $85.11 | $128.82 |
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 $52.48 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.47 | $10.96 | $10.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $10.00 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | UE · Used equipment | $75.86 | $75.86 | $75.86 |
Where Colorado sits
The same service costs 2.6 times more in Montana 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· 24th of 51
$110
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.