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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | None | $15.14 | $15.85 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $27.54 Median $30.20 Typical High $83.18 | Facility | None | $27.54 | $30.20 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.22 Median $15.49 Typical High $38.02 | Professional | None | $11.22 | $15.49 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
Denver HMP Setting Facility Modifier None Typical Low $8.13 Median $15.85 Typical High $33.11 | Facility | None | $8.13 | $15.85 | $33.11 |
Denver HMP Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $37.15 Typical High $57.54 | Professional | None | $21.38 | $37.15 | $57.54 |
Select Health Setting Facility Modifier None Typical Low $28.84 Median $53.70 Typical High $60.26 | Facility | None | $28.84 | $53.70 | $60.26 |
Select Health Setting Professional Modifier None Typical Low $19.95 Median $28.84 Typical High $39.81 | Professional | None | $19.95 | $28.84 | $39.81 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $41.69 | Facility | None | $13.49 | $13.49 | $41.69 |
United Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $19.05 | Professional | None | $11.48 | $12.59 | $19.05 |
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 $7.59 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $7.59 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $3.02 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $2.24 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.51 | $1.58 | $1.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $15.49 Typical High $18.20 | Professional | RR · Rental | $1.55 | $15.49 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | UE · Used equipment | $11.48 | $11.48 | $11.48 |
Where Colorado sits
The same service costs 5.5 times more in Kansas 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· 30th of 51
$15.85
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.