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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $309.03 | Professional | None | $288.40 | $295.12 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $630.96 Typical High $1,737.80 | Facility | None | $575.44 | $630.96 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $645.65 | Professional | None | $229.09 | $295.12 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $724.44 | Facility | None | $158.49 | $309.03 | $724.44 |
Denver HMP Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,174.90 | Professional | None | $416.87 | $776.25 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,258.93 | Facility | None | $602.56 | $1,122.02 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $741.31 | Professional | None | $398.11 | $602.56 | $741.31 |
United Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $245.47 | Facility | None | $138.04 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $380.19 | Professional | None | $218.78 | $245.47 | $380.19 |
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 $147.91 Median $147.91 Typical High $154.88 | Professional | 52 · Reduced service | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 53 · Discontinued | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $30.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $295.12 Typical High $295.12 | Professional | RR · Rental | $29.51 | $295.12 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | UE · Used equipment | $223.87 | $223.87 | $223.87 |
Where Colorado sits
The same service costs 2.7 times more in Montana 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· 39th of 51
$295
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.