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 $36.31 Median $36.31 Typical High $93.33 | Facility | None | $36.31 | $36.31 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $44.67 | Professional | None | $34.67 | $36.31 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $74.13 Typical High $190.55 | Facility | None | $64.57 | $74.13 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $40.74 Typical High $87.10 | Professional | None | $27.54 | $40.74 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Facility | None | $46.77 | $46.77 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $69.18 | Professional | None | $33.88 | $33.88 | $69.18 |
Denver HMP Setting Facility Modifier None Typical Low $20.89 Median $36.31 Typical High $83.18 | Facility | None | $20.89 | $36.31 | $83.18 |
Denver HMP Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $141.25 | Professional | None | $50.12 | $87.10 | $141.25 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $141.25 | Facility | None | $66.07 | $123.03 | $141.25 |
Select Health Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $89.13 | Professional | None | $46.77 | $66.07 | $89.13 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $48.98 | Professional | None | $29.51 | $32.36 | $48.98 |
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 $18.20 Median $18.20 Typical High $21.38 | Professional | 52 · Reduced service | $18.20 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $8.51 | Professional | 53 · Discontinued | $7.24 | $7.24 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.46 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $40.74 Typical High $41.69 | Professional | RR · Rental | $4.07 | $40.74 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | UE · Used equipment | $29.51 | $29.51 | $29.51 |
Where Colorado sits
The same service costs 3.1 times more in Hawaii than in Florida. 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· 47th of 51
$36.31
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.