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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | None | $147.91 | $147.91 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $316.23 Typical High $870.96 | Facility | None | $288.40 | $316.23 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $363.08 | Professional | None | $131.83 | $169.82 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Denver HMP Setting Facility Modifier None Typical Low $89.13 Median $173.78 Typical High $380.19 | Facility | None | $89.13 | $173.78 | $380.19 |
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 $218.78 Median $389.05 Typical High $602.56 | Professional | None | $218.78 | $389.05 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $562.34 Typical High $630.96 | Facility | None | $302.00 | $562.34 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $380.19 | Professional | None | $208.93 | $302.00 | $380.19 |
United Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $208.93 | Facility | None | $186.21 | $208.93 | $208.93 |
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 $74.13 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $29.51 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $17.78 |
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 $125.89 Median $125.89 Typical High $125.89 | Professional | UE · Used equipment | $125.89 | $125.89 | $125.89 |
Where Colorado sits
The same service costs 3.5 times more in Hawaii than in Delaware. 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· 43rd of 51
$162
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.