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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $457.09 | Professional | None | $363.08 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,000.00 Typical High $2,691.53 | Facility | None | $912.01 | $1,000.00 | $2,691.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $912.01 | Professional | None | $281.84 | $416.87 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $223.87 Median $457.09 Typical High $1,047.13 | Facility | None | $223.87 | $457.09 | $1,047.13 |
Denver HMP Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $1,778.28 | Professional | None | $660.69 | $1,230.27 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $1,995.26 | Facility | None | $933.25 | $1,737.80 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,174.90 | Professional | None | $616.60 | $933.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $346.74 | Facility | None | $257.04 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $537.03 | Professional | None | $309.03 | $346.74 | $537.03 |
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 $181.97 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $181.97 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $54.95 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $45.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $416.87 Typical High $416.87 | Professional | RR · Rental | $41.69 | $416.87 | $416.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | UE · Used equipment | $316.23 | $316.23 | $316.23 |
Where Colorado sits
The same service costs 2.8 times more in Montana than in Florida. 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· 24th of 51
$457
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.