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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $218.78 | Professional | None | $173.78 | $173.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $380.19 Typical High $1,023.29 | Facility | None | $346.74 | $380.19 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $457.09 | Professional | None | $138.04 | $218.78 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Denver HMP Setting Facility Modifier None Typical Low $112.20 Median $204.17 Typical High $446.68 | Facility | None | $112.20 | $204.17 | $446.68 |
Denver HMP Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $707.95 | Professional | None | $263.03 | $467.74 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $758.58 | Facility | None | $354.81 | $660.69 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $478.63 | Professional | None | $281.84 | $354.81 | $478.63 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $281.84 | Facility | None | $234.42 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $269.15 | Professional | None | $158.49 | $173.78 | $269.15 |
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 $87.10 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $87.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $34.67 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $218.78 Typical High $218.78 | Professional | RR · Rental | $21.88 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | UE · Used equipment | $162.18 | $162.18 | $162.18 |
Where Colorado sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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
$200
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.