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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $309.03 Typical High $831.76 | Facility | None | $275.42 | $309.03 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $371.54 | Professional | None | $112.20 | $169.82 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Denver HMP Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $363.08 | Facility | None | $89.13 | $177.83 | $363.08 |
Denver HMP Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $575.44 | Professional | None | $208.93 | $380.19 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $537.03 Typical High $602.56 | Facility | None | $288.40 | $537.03 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $407.38 | Professional | None | $245.47 | $288.40 | $407.38 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $229.09 | Facility | None | $186.21 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $213.80 | Professional | None | $125.89 | $138.04 | $213.80 |
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 $70.79 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $70.79 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $28.18 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $169.82 Typical High $169.82 | Professional | RR · Rental | $16.98 | $169.82 | $169.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | UE · Used equipment | $128.82 | $128.82 | $128.82 |
Where Colorado sits
The same service costs 4.0 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· 46th of 51
$158
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.