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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | None | $53.70 | $53.70 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $281.84 | Facility | None | $93.33 | $102.33 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $125.89 | Professional | None | $56.23 | $66.07 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Facility | None | $60.26 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Denver HMP Setting Facility Modifier None Typical Low $45.71 Median $70.79 Typical High $120.23 | Facility | None | $45.71 | $70.79 | $120.23 |
Denver HMP Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $194.98 | Professional | None | $74.13 | $125.89 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $204.17 | Facility | None | $97.72 | $181.97 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $138.04 | Professional | None | $69.18 | $97.72 | $138.04 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $75.86 | Professional | None | $44.67 | $47.86 | $75.86 |
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 $26.92 Median $26.92 Typical High $30.90 | Professional | 52 · Reduced service | $26.92 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $12.30 | Professional | 53 · Discontinued | $10.72 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $6.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $57.54 Typical High $57.54 | Professional | RR · Rental | $6.61 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | UE · Used equipment | $42.66 | $42.66 | $48.98 |
Where Colorado sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 43rd of 51
$57.54
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.