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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $67.61 | Professional | None | $63.10 | $66.07 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $125.89 Typical High $346.74 | Facility | None | $114.82 | $125.89 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $154.88 | Professional | None | $63.10 | $69.18 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Denver HMP Setting Facility Modifier None Typical Low $53.70 Median $75.86 Typical High $141.25 | Facility | None | $53.70 | $75.86 | $141.25 |
Denver HMP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $239.88 | Professional | None | $89.13 | $154.88 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $218.78 Typical High $251.19 | Facility | None | $120.23 | $218.78 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $165.96 | Professional | None | $83.18 | $120.23 | $165.96 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $63.10 | Facility | None | $57.54 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $81.28 | Professional | None | $48.98 | $51.29 | $81.28 |
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 $31.62 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $31.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.55 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.31 | $6.61 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $67.61 Typical High $67.61 | Professional | RR · Rental | $6.92 | $67.61 | $67.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $52.48 | Professional | UE · Used equipment | $50.12 | $50.12 | $52.48 |
Where Colorado sits
The same service costs 2.4 times more in Montana 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· 31st of 51
$66.07
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.