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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | None | $426.58 | $426.58 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $933.25 Typical High $2,511.89 | Facility | None | $851.14 | $933.25 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $1,148.15 | Professional | None | $363.08 | $524.81 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $275.42 Median $549.54 Typical High $1,096.48 | Facility | None | $275.42 | $549.54 | $1,096.48 |
Denver HMP Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $1,778.28 | Professional | None | $616.60 | $1,148.15 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $1,621.81 Typical High $1,862.09 | Facility | None | $870.96 | $1,621.81 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,096.48 | Professional | None | $616.60 | $870.96 | $1,096.48 |
United Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $524.81 | Facility | None | $501.19 | $524.81 | $524.81 |
United Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $660.69 | Professional | None | $389.05 | $426.58 | $660.69 |
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 $213.80 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $213.80 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $87.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $524.81 Typical High $524.81 | Professional | RR · Rental | $52.48 | $524.81 | $524.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | UE · Used equipment | $389.05 | $389.05 | $389.05 |
Where Colorado sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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
$490
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.