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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $7,413.10 | Facility | None | $2,511.89 | $2,754.23 | $7,413.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $3,801.89 | Professional | None | $1,174.90 | $1,778.28 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,318.26 | $1,819.70 |
Denver HMP Setting Facility Modifier None Typical Low $741.31 Median $1,445.44 Typical High $2,951.21 | Facility | None | $741.31 | $1,445.44 | $2,951.21 |
Denver HMP Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $3,388.44 Typical High $5,248.07 | Professional | None | $1,819.70 | $3,388.44 | $5,248.07 |
Select Health Setting Facility Modifier None Typical Low $2,570.40 Median $4,786.30 Typical High $5,495.41 | Facility | None | $2,570.40 | $4,786.30 | $5,495.41 |
Select Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $3,235.94 | Professional | None | $1,819.70 | $2,570.40 | $3,235.94 |
United Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,148.15 | Facility | None | $870.96 | $1,148.15 | $1,148.15 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,148.15 | $1,737.80 |
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 $630.96 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $1,778.28 Typical High $1,778.28 | Professional | RR · Rental | $169.82 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | UE · Used equipment | $1,288.25 | $1,288.25 | $1,288.25 |
Where Colorado sits
The same service costs 2.3 times more in Wisconsin than in Pennsylvania. 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· 46th of 51
$1,318
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.