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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $128.82 | Professional | None | $107.15 | $112.20 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $588.84 | Facility | None | $194.98 | $218.78 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $269.15 | Professional | None | $79.43 | $112.20 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Denver HMP Setting Facility Modifier None Typical Low $57.54 Median $112.20 Typical High $239.88 | Facility | None | $57.54 | $112.20 | $239.88 |
Denver HMP Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $389.05 | Professional | None | $154.88 | $269.15 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $380.19 Typical High $426.58 | Facility | None | $204.17 | $380.19 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $288.40 | Professional | None | $144.54 | $204.17 | $288.40 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $295.12 | Facility | None | $97.72 | $97.72 | $295.12 |
United Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $134.90 | Professional | None | $81.28 | $89.13 | $134.90 |
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 $53.70 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $53.70 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $21.38 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $16.22 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.72 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $112.20 Typical High $128.82 | Professional | RR · Rental | $11.22 | $112.20 | $128.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $81.28 | $81.28 | $81.28 |
Where Colorado sits
The same service costs 2.3 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· 30th of 51
$112
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.