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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | None | $169.82 | $169.82 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $1,000.00 | Facility | None | $331.13 | $363.08 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $478.63 | Professional | None | $158.49 | $218.78 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $213.80 Typical High $426.58 | Facility | None | $109.65 | $213.80 | $426.58 |
Denver HMP Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $691.83 | Professional | None | $251.19 | $446.68 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $630.96 Typical High $724.44 | Facility | None | $346.74 | $630.96 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $426.58 | Professional | None | $251.19 | $346.74 | $426.58 |
United Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $173.78 | Facility | None | $158.49 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $257.04 | Professional | None | $151.36 | $169.82 | $257.04 |
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 $85.11 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $33.11 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $218.78 Typical High $218.78 | Professional | RR · Rental | $21.38 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | UE · Used equipment | $162.18 | $162.18 | $162.18 |
Where Colorado sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 51st of 51
$200
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.