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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $257.04 | Professional | None | $199.53 | $199.53 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $426.58 Typical High $1,174.90 | Facility | None | $389.05 | $426.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $524.81 | Professional | None | $165.96 | $239.88 | $524.81 |
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 $128.82 Median $229.09 Typical High $512.86 | Facility | None | $128.82 | $229.09 | $512.86 |
Denver HMP Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $812.83 | Professional | None | $295.12 | $524.81 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $851.14 | Facility | None | $407.38 | $758.58 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $512.86 | Professional | None | $309.03 | $407.38 | $512.86 |
United Setting Facility Modifier None Typical Low $218.78 Median $245.47 Typical High $245.47 | Facility | None | $218.78 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $309.03 | Professional | None | $177.83 | $199.53 | $309.03 |
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 $100.00 Median $100.00 Typical High $128.82 | Professional | 52 · Reduced service | $100.00 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $51.29 | Professional | 53 · Discontinued | $39.81 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $239.88 Typical High $239.88 | Professional | RR · Rental | $23.99 | $239.88 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
Where Colorado sits
The same service costs 2.5 times more in Hawaii 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· 48th of 51
$224
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.