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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | None | $47.86 | $47.86 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $251.19 | Facility | None | $85.11 | $93.33 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $123.03 | Professional | None | $50.12 | $57.54 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Denver HMP Setting Facility Modifier None Typical Low $45.71 Median $63.10 Typical High $109.65 | Facility | None | $45.71 | $63.10 | $109.65 |
Denver HMP Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $181.97 | Professional | None | $66.07 | $114.82 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $162.18 Typical High $186.21 | Facility | None | $87.10 | $162.18 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $117.49 | Professional | None | $69.18 | $87.10 | $117.49 |
United Setting Facility Modifier None Typical Low $16.98 Median $39.81 Typical High $39.81 | Facility | None | $16.98 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $67.61 | Professional | None | $40.74 | $42.66 | $67.61 |
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 $23.99 Median $23.99 Typical High $26.92 | Professional | 52 · Reduced service | $23.99 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $10.72 | Professional | 53 · Discontinued | $9.55 | $9.55 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $8.13 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $50.12 Typical High $50.12 | Professional | RR · Rental | $5.75 | $50.12 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | UE · Used equipment | $38.02 | $38.02 | $43.65 |
Where Colorado sits
The same service costs 3.3 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
$48.98
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.