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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,691.53 | Professional | None | $2,187.76 | $2,187.76 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $4,677.35 Typical High $12,882.50 | Facility | None | $4,265.80 | $4,677.35 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,165.95 | Professional | None | $1,905.46 | $3,019.95 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,187.76 | $3,019.95 |
Denver HMP Setting Facility Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $5,623.41 | Facility | None | $2,187.76 | $2,884.03 | $5,623.41 |
Denver HMP Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,090.30 Median $5,754.40 Typical High $8,912.51 | Professional | None | $3,090.30 | $5,754.40 | $8,912.51 |
Select Health Setting Facility Modifier None Typical Low $4,466.84 Median $8,317.64 Typical High $9,332.54 | Facility | None | $4,466.84 | $8,317.64 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,466.84 Typical High $5,623.41 | Professional | None | $3,467.37 | $4,466.84 | $5,623.41 |
United Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,819.70 | $1,995.26 | $3,019.95 |
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 $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | 53 · Discontinued | $436.52 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $302.00 Median $3,019.95 Typical High $3,019.95 | Professional | RR · Rental | $302.00 | $3,019.95 | $3,019.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | UE · Used equipment | $2,290.87 | $2,290.87 | $2,290.87 |
Where Colorado sits
The same service costs 2.4 times more in Hawaii than in West Virginia. 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· 43rd of 51
$2,455
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.