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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | None | $57.54 | $57.54 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $109.65 Typical High $295.12 | Facility | None | $100.00 | $109.65 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $141.25 | Professional | None | $39.81 | $61.66 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Denver HMP Setting Facility Modifier None Typical Low $33.11 Median $58.88 Typical High $128.82 | Facility | None | $33.11 | $58.88 | $128.82 |
Denver HMP Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $213.80 | Professional | None | $77.62 | $134.90 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $190.55 Typical High $218.78 | Facility | None | $104.71 | $190.55 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $138.04 | Professional | None | $89.13 | $104.71 | $138.04 |
United Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $61.66 | Facility | None | $46.77 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $75.86 | Professional | None | $45.71 | $51.29 | $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 $28.18 Median $28.18 Typical High $35.48 | Professional | 52 · Reduced service | $28.18 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | 53 · Discontinued | $11.48 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.72 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $7.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $61.66 Typical High $61.66 | Professional | RR · Rental | $6.17 | $61.66 | $61.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | UE · Used equipment | $46.77 | $46.77 | $46.77 |
Where Colorado sits
The same service costs 2.7 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
$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.