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 $190.55 Median $190.55 Typical High $489.78 | Facility | None | $190.55 | $190.55 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | None | $190.55 | $190.55 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $371.54 Typical High $1,000.00 | Facility | None | $331.13 | $371.54 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $446.68 | Professional | None | $147.91 | $213.80 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $245.47 | Professional | None | $165.96 | $165.96 | $245.47 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $436.52 | Facility | None | $109.65 | $190.55 | $436.52 |
Denver HMP Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $660.69 | Professional | None | $251.19 | $457.09 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $645.65 Typical High $724.44 | Facility | None | $346.74 | $645.65 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $489.78 | Professional | None | $309.03 | $346.74 | $489.78 |
United Setting Facility Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Facility | None | $229.09 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $257.04 | Professional | None | $154.88 | $169.82 | $257.04 |
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 $95.50 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $38.02 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $213.80 Typical High $218.78 | Professional | RR · Rental | $21.38 | $213.80 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | UE · Used equipment | $154.88 | $154.88 | $154.88 |
Where Colorado sits
The same service costs 3.5 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· 45th of 51
$191
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.