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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | None | $158.49 | $162.18 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $354.81 Typical High $954.99 | Facility | None | $323.59 | $354.81 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $389.05 | Professional | None | $128.82 | $181.97 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Denver HMP Setting Facility Modifier None Typical Low $85.11 Median $169.82 Typical High $371.54 | Facility | None | $85.11 | $169.82 | $371.54 |
Denver HMP Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $660.69 | Professional | None | $245.47 | $436.52 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $616.60 Typical High $707.95 | Facility | None | $331.13 | $616.60 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $416.87 | Professional | None | $234.42 | $331.13 | $416.87 |
United Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $141.25 | Facility | None | $134.90 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $204.17 | Professional | None | $120.23 | $131.83 | $204.17 |
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 $79.43 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $32.36 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.85 | $16.22 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $181.97 Typical High $181.97 | Professional | RR · Rental | $17.78 | $181.97 | $181.97 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | UE · Used equipment | $131.83 | $131.83 | $131.83 |
Where Colorado sits
The same service costs 2.8 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· 38th of 51
$162
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.