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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | None | $44.67 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $112.20 Typical High $302.00 | Facility | None | $102.33 | $112.20 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $53.70 Typical High $117.49 | Professional | None | $33.11 | $53.70 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $53.70 | Professional | None | $35.48 | $35.48 | $53.70 |
Denver HMP Setting Facility Modifier None Typical Low $25.12 Median $52.48 Typical High $117.49 | Facility | None | $25.12 | $52.48 | $117.49 |
Denver HMP Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $213.80 | Professional | None | $79.43 | $138.04 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $194.98 Typical High $223.87 | Facility | None | $107.15 | $194.98 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $147.91 | Professional | None | $69.18 | $107.15 | $147.91 |
United Setting Facility Modifier None Typical Low $19.95 Median $39.81 Typical High $39.81 | Facility | None | $19.95 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $60.26 | Professional | None | $35.48 | $38.90 | $60.26 |
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 $22.39 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $22.39 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.91 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.47 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $5.37 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Where Colorado sits
The same service costs 2.8 times more in Montana than in New Jersey. 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· 30th of 51
$52.48
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.