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 $154.88 Median $154.88 Typical High $398.11 | Facility | None | $154.88 | $154.88 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $812.83 | Facility | None | $269.15 | $302.00 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $363.08 | Professional | None | $147.91 | $158.49 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Denver HMP Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $331.13 | Facility | None | $131.83 | $177.83 | $331.13 |
Denver HMP Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $537.03 | Professional | None | $204.17 | $363.08 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $524.81 Typical High $588.84 | Facility | None | $281.84 | $524.81 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $398.11 | Professional | None | $199.53 | $281.84 | $398.11 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $190.55 | Professional | None | $114.82 | $123.03 | $190.55 |
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 $75.86 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $75.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.20 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $15.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $158.49 Typical High $158.49 | Professional | RR · Rental | $15.85 | $158.49 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $120.23 | Professional | UE · Used equipment | $117.49 | $117.49 | $120.23 |
Where Colorado sits
The same service costs 2.2 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· 36th of 51
$155
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.