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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | None | $446.68 | $446.68 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $2,344.23 | Facility | None | $776.25 | $851.14 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $1,258.93 | Professional | None | $309.03 | $478.63 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Denver HMP Setting Facility Modifier None Typical Low $257.04 Median $446.68 Typical High $1,000.00 | Facility | None | $257.04 | $446.68 | $1,000.00 |
Denver HMP Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,548.82 | Professional | None | $562.34 | $1,047.13 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $1,698.24 | Facility | None | $812.83 | $1,479.11 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,071.52 | Professional | None | $645.65 | $812.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Facility | None | $478.63 | $524.81 | $524.81 |
United Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $588.84 | Professional | None | $354.81 | $398.11 | $588.84 |
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 $223.87 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $478.63 Typical High $512.86 | Professional | RR · Rental | $47.86 | $478.63 | $512.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | UE · Used equipment | $363.08 | $363.08 | $363.08 |
Where Colorado sits
The same service costs 3.2 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· 40th of 51
$447
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.