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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | None | $208.93 | $223.87 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $478.63 Typical High $1,318.26 | Facility | None | $436.52 | $478.63 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $524.81 | Professional | None | $151.36 | $218.78 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $117.49 Median $234.42 Typical High $501.19 | Facility | None | $117.49 | $234.42 | $501.19 |
Denver HMP Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $891.25 | Professional | None | $331.13 | $588.84 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $954.99 | Facility | None | $457.09 | $851.14 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $562.34 | Professional | None | $309.03 | $457.09 | $562.34 |
United Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Facility | None | $151.36 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $281.84 | Professional | None | $165.96 | $181.97 | $281.84 |
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 $104.71 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $41.69 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $218.78 Typical High $218.78 | Professional | RR · Rental | $21.88 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Where Colorado sits
The same service costs 2.7 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· 34th 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.