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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $562.34 Typical High $1,513.56 | Facility | None | $501.19 | $562.34 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $691.83 | Professional | None | $208.93 | $316.23 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Denver HMP Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $660.69 | Facility | None | $165.96 | $323.59 | $660.69 |
Denver HMP Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $691.83 Typical High $1,047.13 | Professional | None | $371.54 | $691.83 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $977.24 Typical High $1,096.48 | Facility | None | $524.81 | $977.24 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $707.95 | Professional | None | $436.52 | $524.81 | $707.95 |
United Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $416.87 | Facility | None | $346.74 | $416.87 | $416.87 |
United Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $398.11 | Professional | None | $234.42 | $257.04 | $398.11 |
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 $128.82 Median $128.82 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $44.67 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $31.62 Median $316.23 Typical High $316.23 | Professional | RR · Rental | $31.62 | $316.23 | $316.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | UE · Used equipment | $234.42 | $234.42 | $234.42 |
Where Colorado sits
The same service costs 3.7 times more in Hawaii 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· 42nd of 51
$295
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.