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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,737.80 | $1,737.80 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $3,715.35 Typical High $10,232.93 | Facility | None | $3,388.44 | $3,715.35 | $10,232.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $4,570.88 | Professional | None | $1,445.44 | $1,862.09 | $4,570.88 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,862.09 | $2,570.40 |
Denver HMP Setting Facility Modifier None Typical Low $1,000.00 Median $1,949.84 Typical High $4,073.80 | Facility | None | $1,000.00 | $1,949.84 | $4,073.80 |
Denver HMP Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $4,570.88 Typical High $7,079.46 | Professional | None | $2,454.71 | $4,570.88 | $7,079.46 |
Select Health Setting Facility Modifier None Typical Low $3,548.13 Median $6,606.93 Typical High $7,413.10 | Facility | None | $3,548.13 | $6,606.93 | $7,413.10 |
Select Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,548.13 Typical High $4,466.84 | Professional | None | $2,454.71 | $3,548.13 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,288.25 | $1,659.59 | $1,659.59 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,548.82 | $2,344.23 |
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 $870.96 Median $870.96 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $186.21 Median $1,862.09 Typical High $1,862.09 | Professional | RR · Rental | $186.21 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | UE · Used equipment | $1,412.54 | $1,412.54 | $1,412.54 |
Where Colorado sits
The same service costs 2.4 times more in Wisconsin 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· 40th of 51
$1,862
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.