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 $4,073.80 Median $4,073.80 Typical High $4,073.80 | Facility | None | $4,073.80 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,715.35 | $4,073.80 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $8,709.64 Typical High $23,988.33 | Facility | None | $7,943.28 | $8,709.64 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $3,630.78 Typical High $8,128.31 | Professional | None | $2,630.27 | $3,630.78 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Denver HMP Setting Facility Modifier None Typical Low $1,949.84 Median $4,073.80 Typical High $9,120.11 | Facility | None | $1,949.84 | $4,073.80 | $9,120.11 |
Denver HMP Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,754.40 Median $10,715.19 Typical High $16,595.87 | Professional | None | $5,754.40 | $10,715.19 | $16,595.87 |
Select Health Setting Facility Modifier None Typical Low $8,317.64 Median $15,135.61 Typical High $17,378.01 | Facility | None | $8,317.64 | $15,135.61 | $17,378.01 |
Select Health Setting Professional Modifier None Typical Low $5,754.40 Median $8,317.64 Typical High $11,481.54 | Professional | None | $5,754.40 | $8,317.64 | $11,481.54 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,073.80 | $4,897.79 | $4,897.79 |
United Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,754.23 | $3,019.95 | $4,677.35 |
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 $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,862.09 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $562.34 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $371.54 | $407.38 | $407.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $363.08 Median $3,630.78 Typical High $3,630.78 | Professional | RR · Rental | $363.08 | $3,630.78 | $3,630.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | UE · Used equipment | $2,754.23 | $2,754.23 | $2,754.23 |
Where Colorado sits
The same service costs 3.9 times more in Hawaii than in Washington, DC. 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· 31st of 51
$4,074
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.