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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | None | $87.10 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $218.78 Typical High $602.56 | Facility | None | $199.53 | $218.78 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $204.17 | Professional | None | $61.66 | $93.33 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Denver HMP Setting Facility Modifier None Typical Low $48.98 Median $102.33 Typical High $229.09 | Facility | None | $48.98 | $102.33 | $229.09 |
Denver HMP Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $398.11 | Professional | None | $154.88 | $269.15 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $436.52 | Facility | None | $208.93 | $389.05 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $295.12 | Professional | None | $134.90 | $208.93 | $295.12 |
United Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $75.86 | Facility | None | $60.26 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $117.49 | Professional | None | $69.18 | $75.86 | $117.49 |
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 $43.65 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $43.65 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $17.38 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.71 | $10.23 | $10.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $93.33 Typical High $93.33 | Professional | RR · Rental | $9.33 | $93.33 | $93.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | UE · Used equipment | $69.18 | $69.18 | $69.18 |
Where Colorado sits
The same service costs 2.9 times more in Montana 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· 26th of 51
$102
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.