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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | None | $316.23 | $316.23 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $676.08 Typical High $1,819.70 | Facility | None | $616.60 | $676.08 | $1,819.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $831.76 | Professional | None | $263.03 | $380.19 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $467.74 | Professional | None | $338.84 | $338.84 | $467.74 |
Denver HMP Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $794.33 | Facility | None | $204.17 | $363.08 | $794.33 |
Denver HMP Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $1,288.25 | Professional | None | $446.68 | $831.76 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $1,174.90 Typical High $1,348.96 | Facility | None | $645.65 | $1,174.90 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $851.14 | Professional | None | $489.78 | $645.65 | $851.14 |
United Setting Facility Modifier None Typical Low $380.19 Median $416.87 Typical High $416.87 | Facility | None | $380.19 | $416.87 | $416.87 |
United Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $478.63 | Professional | None | $281.84 | $316.23 | $478.63 |
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 $158.49 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $63.10 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $60.26 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $380.19 Typical High $380.19 | Professional | RR · Rental | $38.02 | $380.19 | $380.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | UE · Used equipment | $288.40 | $288.40 | $288.40 |
Where Colorado sits
The same service costs 2.9 times more in Hawaii than in Florida. 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· 43rd of 51
$355
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.