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 $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,311.31 | Professional | None | $3,162.28 | $3,162.28 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $6,760.83 Typical High $18,197.01 | Facility | None | $6,165.95 | $6,760.83 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $6,918.31 | Professional | None | $2,089.30 | $3,162.28 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,754.23 | $2,754.23 | $3,715.35 |
Denver HMP Setting Facility Modifier None Typical Low $1,698.24 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,698.24 | $3,311.31 | $7,943.28 |
Denver HMP Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,466.84 Median $8,317.64 Typical High $12,589.25 | Professional | None | $4,466.84 | $8,317.64 | $12,589.25 |
Select Health Setting Facility Modifier None Typical Low $6,456.54 Median $11,748.98 Typical High $13,489.63 | Facility | None | $6,456.54 | $11,748.98 | $13,489.63 |
Select Health Setting Professional Modifier None Typical Low $4,466.84 Median $6,456.54 Typical High $7,943.28 | Professional | None | $4,466.84 | $6,456.54 | $7,943.28 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $8,511.38 | Facility | None | $3,467.37 | $3,467.37 | $8,511.38 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $3,981.07 | Professional | None | $2,344.23 | $2,630.27 | $3,981.07 |
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 $1,548.82 Median $1,548.82 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | 53 · Discontinued | $630.96 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $316.23 Median $3,162.28 Typical High $3,162.28 | Professional | RR · Rental | $316.23 | $3,162.28 | $3,162.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | UE · Used equipment | $2,398.83 | $2,398.83 | $2,398.83 |
Where Colorado sits
The same service costs 2.9 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· 36th of 51
$3,162
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.