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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $19.95 | Professional | None | $19.05 | $19.95 | $19.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $104.71 | Facility | None | $34.67 | $38.02 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $18.62 Typical High $46.77 | Professional | None | $13.80 | $18.62 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Denver HMP Setting Facility Modifier None Typical Low $10.23 Median $19.95 Typical High $42.66 | Facility | None | $10.23 | $19.95 | $42.66 |
Denver HMP Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $46.77 Typical High $72.44 | Professional | None | $27.54 | $46.77 | $72.44 |
Select Health Setting Facility Modifier None Typical Low $36.31 Median $67.61 Typical High $75.86 | Facility | None | $36.31 | $67.61 | $75.86 |
Select Health Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $51.29 | Professional | None | $25.70 | $36.31 | $51.29 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $23.44 | Professional | None | $14.13 | $15.85 | $23.44 |
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 $9.55 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $9.55 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.89 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $2.88 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.95 | $2.00 | $2.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $18.62 Typical High $18.62 | Professional | RR · Rental | $1.82 | $18.62 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | UE · Used equipment | $13.80 | $13.80 | $13.80 |
Where Colorado sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$19.95
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.