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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | None | $660.69 | $660.69 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $3,467.37 | Facility | None | $1,148.15 | $1,258.93 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,548.82 | Professional | None | $467.74 | $741.31 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $707.95 Typical High $1,513.56 | Facility | None | $380.19 | $707.95 | $1,513.56 |
Denver HMP Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $2,290.87 | Professional | None | $831.76 | $1,548.82 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,238.72 Typical High $2,511.89 | Facility | None | $1,202.26 | $2,238.72 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,584.89 | Professional | None | $831.76 | $1,202.26 | $1,584.89 |
United Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $912.01 | Facility | None | $776.25 | $912.01 | $912.01 |
United Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $891.25 | Professional | None | $537.03 | $588.84 | $891.25 |
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 $331.13 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $331.13 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $70.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $74.13 Median $741.31 Typical High $758.58 | Professional | RR · Rental | $74.13 | $741.31 | $758.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | UE · Used equipment | $537.03 | $537.03 | $537.03 |
Where Colorado sits
The same service costs 4.6 times more in Hawaii 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· 41st of 51
$661
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.