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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,570.40 | Professional | None | $2,344.23 | $2,344.23 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $5,011.87 Typical High $13,803.84 | Facility | None | $4,570.88 | $5,011.87 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $5,495.41 | Professional | None | $1,905.46 | $2,511.89 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
Denver HMP Setting Facility Modifier None Typical Low $1,318.26 Median $2,570.40 Typical High $6,025.60 | Facility | None | $1,318.26 | $2,570.40 | $6,025.60 |
Denver HMP Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $6,165.95 Typical High $9,549.93 | Professional | None | $3,311.31 | $6,165.95 | $9,549.93 |
Select Health Setting Facility Modifier None Typical Low $4,786.30 Median $8,912.51 Typical High $10,000.00 | Facility | None | $4,786.30 | $8,912.51 | $10,000.00 |
Select Health Setting Professional Modifier None Typical Low $3,311.31 Median $4,786.30 Typical High $6,760.83 | Professional | None | $3,311.31 | $4,786.30 | $6,760.83 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $6,606.93 | Facility | None | $2,398.83 | $2,398.83 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,041.74 | $3,162.28 |
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 $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | 53 · Discontinued | $467.74 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $251.19 Median $2,511.89 Typical High $2,511.89 | Professional | RR · Rental | $251.19 | $2,511.89 | $2,511.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | UE · Used equipment | $1,905.46 | $1,905.46 | $1,905.46 |
Where Colorado sits
The same service costs 2.1 times more in Montana than in South Carolina. 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· 39th of 51
$2,455
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.