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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | None | $177.83 | $177.83 | $208.93 |
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 $158.49 Median $204.17 Typical High $524.81 | Professional | None | $158.49 | $204.17 | $524.81 |
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 $107.15 Median $204.17 Typical High $436.52 | Facility | None | $107.15 | $204.17 | $436.52 |
Denver HMP Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $724.44 | Professional | None | $263.03 | $467.74 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $660.69 Typical High $758.58 | Facility | None | $363.08 | $660.69 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $446.68 | Professional | None | $275.42 | $363.08 | $446.68 |
United Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $173.78 | Facility | None | $169.82 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $257.04 | Professional | None | $151.36 | $165.96 | $257.04 |
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 $104.71 | Professional | 52 · Reduced service | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $41.69 | Professional | 53 · Discontinued | $35.48 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $204.17 Typical High $204.17 | Professional | RR · Rental | $20.42 | $204.17 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | UE · Used equipment | $154.88 | $154.88 | $154.88 |
Where Colorado sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 51st of 51
$178
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.