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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | None | $457.09 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $2,951.21 | Facility | None | $1,000.00 | $1,096.48 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $1,000.00 | Professional | None | $354.81 | $478.63 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
Denver HMP Setting Facility Modifier None Typical Low $245.47 Median $512.86 Typical High $1,148.15 | Facility | None | $245.47 | $512.86 | $1,148.15 |
Denver HMP Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $1,949.84 | Professional | None | $724.44 | $1,348.96 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $2,187.76 | Facility | None | $1,023.29 | $1,905.46 | $2,187.76 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,445.44 | Professional | None | $724.44 | $1,023.29 | $1,445.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Facility | None | $501.19 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $588.84 | Professional | None | $346.74 | $380.19 | $588.84 |
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 $229.09 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $478.63 Typical High $478.63 | Professional | RR · Rental | $45.71 | $478.63 | $478.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | UE · Used equipment | $346.74 | $346.74 | $346.74 |
Where Colorado sits
The same service costs 4.1 times more in Hawaii than in Kansas. 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
$513
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.