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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | None | $20.89 | $21.88 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $41.69 Typical High $114.82 | Facility | None | $38.02 | $41.69 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $51.29 | Professional | None | $15.14 | $20.89 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Denver HMP Setting Facility Modifier None Typical Low $10.96 Median $21.88 Typical High $46.77 | Facility | None | $10.96 | $21.88 | $46.77 |
Denver HMP Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $79.43 | Professional | None | $29.51 | $51.29 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $72.44 Typical High $83.18 | Facility | None | $39.81 | $72.44 | $83.18 |
Select Health Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $54.95 | Professional | None | $27.54 | $39.81 | $54.95 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $25.70 | Professional | None | $15.49 | $16.98 | $25.70 |
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 $10.47 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.47 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.17 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $3.16 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.09 | $2.19 | $2.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.09 Median $20.89 Typical High $20.89 | Professional | RR · Rental | $2.09 | $20.89 | $20.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | UE · Used equipment | $15.49 | $15.49 | $15.49 |
Where Colorado sits
The same service costs 2.2 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· 27th of 51
$21.88
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.