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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $28.84 | Professional | None | $26.92 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $54.95 Typical High $151.36 | Facility | None | $50.12 | $54.95 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $27.54 Typical High $67.61 | Professional | None | $19.95 | $27.54 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Denver HMP Setting Facility Modifier None Typical Low $14.45 Median $28.84 Typical High $61.66 | Facility | None | $14.45 | $28.84 | $61.66 |
Denver HMP Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $67.61 Typical High $109.65 | Professional | None | $38.90 | $67.61 | $109.65 |
Select Health Setting Facility Modifier None Typical Low $52.48 Median $95.50 Typical High $109.65 | Facility | None | $52.48 | $95.50 | $109.65 |
Select Health Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $72.44 | Professional | None | $36.31 | $52.48 | $72.44 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $33.88 | Professional | None | $20.42 | $22.39 | $33.88 |
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 $13.80 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $13.80 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.50 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.17 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.75 | $2.88 | $2.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $27.54 Typical High $27.54 | Professional | RR · Rental | $2.75 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Where Colorado sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 30th of 51
$28.84
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.