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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | None | $234.42 | $234.42 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $457.09 Typical High $1,230.27 | Facility | None | $416.87 | $457.09 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $549.54 | Professional | None | $165.96 | $251.19 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Denver HMP Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $524.81 | Facility | None | $131.83 | $234.42 | $524.81 |
Denver HMP Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $812.83 | Professional | None | $316.23 | $562.34 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $912.01 | Facility | None | $426.58 | $794.33 | $912.01 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $562.34 | Professional | None | $302.00 | $426.58 | $562.34 |
United Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $275.42 | Facility | None | $213.80 | $275.42 | $275.42 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $309.03 | Professional | None | $186.21 | $204.17 | $309.03 |
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 $117.49 Median $117.49 Typical High $123.03 | Professional | 52 · Reduced service | $117.49 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 53 · Discontinued | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $37.15 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $24.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $251.19 Typical High $269.15 | Professional | RR · Rental | $25.12 | $251.19 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | UE · Used equipment | $186.21 | $186.21 | $186.21 |
Where Colorado sits
The same service costs 4.7 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
$234
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.