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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,570.40 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,495.41 Typical High $15,135.61 | Facility | None | $5,011.87 | $5,495.41 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $6,025.60 | Professional | None | $2,041.74 | $2,818.38 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,630.78 | Professional | None | $2,691.53 | $2,691.53 | $3,630.78 |
Denver HMP Setting Facility Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $6,456.54 | Facility | None | $1,479.11 | $2,951.21 | $6,456.54 |
Denver HMP Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $6,760.83 Typical High $10,471.29 | Professional | None | $3,630.78 | $6,760.83 | $10,471.29 |
Select Health Setting Facility Modifier None Typical Low $5,248.07 Median $9,772.37 Typical High $10,964.78 | Facility | None | $5,248.07 | $9,772.37 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $3,981.07 Median $5,248.07 Typical High $6,606.93 | Professional | None | $3,981.07 | $5,248.07 | $6,606.93 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,090.30 | $3,311.31 | $3,311.31 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $3,548.13 | Professional | None | $2,089.30 | $2,290.87 | $3,548.13 |
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 $1,288.25 Median $1,288.25 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 53 · Discontinued | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $281.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $281.84 Median $2,818.38 Typical High $2,818.38 | Professional | RR · Rental | $281.84 | $2,818.38 | $2,818.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | UE · Used equipment | $2,089.30 | $2,089.30 | $2,089.30 |
Where Colorado sits
The same service costs 3.0 times more in Hawaii than in Pennsylvania. 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
$2,692
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.