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 $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $27.54 Typical High $27.54 | Professional | None | $26.92 | $27.54 | $27.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $53.70 Typical High $144.54 | Facility | None | $48.98 | $53.70 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $64.57 | Professional | None | $19.50 | $26.92 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Denver HMP Setting Facility Modifier None Typical Low $14.13 Median $27.54 Typical High $60.26 | Facility | None | $14.13 | $27.54 | $60.26 |
Denver HMP Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $66.07 Typical High $100.00 | Professional | None | $38.02 | $66.07 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $50.12 Median $93.33 Typical High $107.15 | Facility | None | $50.12 | $93.33 | $107.15 |
Select Health Setting Professional Modifier None Typical Low $35.48 Median $50.12 Typical High $70.79 | Professional | None | $35.48 | $50.12 | $70.79 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $33.11 | Professional | None | $19.95 | $21.88 | $33.11 |
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 $13.49 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $13.49 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $5.37 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.17 Typical High $4.17 | Professional | 55 · Aftercare only | $3.98 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.69 | $2.75 | $2.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $26.92 Typical High $26.92 | Professional | RR · Rental | $2.69 | $26.92 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | UE · Used equipment | $19.95 | $19.95 | $19.95 |
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· 26th of 51
$27.54
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.