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 $112.20 Median $112.20 Typical High $154.88 | Professional | None | $112.20 | $112.20 | $154.88 |
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 $109.65 Median $120.23 Typical High $269.15 | Professional | None | $109.65 | $120.23 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $120.23 Typical High $120.23 | Professional | RR · Rental | $12.02 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Denver HMP Setting Facility Modifier None Typical Low $95.50 Median $131.83 Typical High $239.88 | Facility | None | $95.50 | $131.83 | $239.88 |
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 $154.88 Median $269.15 Typical High $407.38 | Professional | None | $154.88 | $269.15 | $407.38 |
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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $141.25 | Professional | None | $85.11 | $89.13 | $141.25 |
5 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 $56.23 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $16.60 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | UE · Used equipment | $87.10 | $87.10 | $89.13 |
Where Colorado sits
The same service costs 2.1 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· 42nd 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.