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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | None | $316.23 | $316.23 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $691.83 Typical High $1,862.09 | Facility | None | $616.60 | $691.83 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $912.01 | Professional | None | $309.03 | $407.38 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Denver HMP Setting Facility Modifier None Typical Low $204.17 Median $389.05 Typical High $812.83 | Facility | None | $204.17 | $389.05 | $812.83 |
Denver HMP Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $1,288.25 | Professional | None | $457.09 | $851.14 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $1,348.96 | Facility | None | $645.65 | $1,202.26 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $870.96 | Professional | None | $562.34 | $645.65 | $870.96 |
United Setting Facility Modifier None Typical Low $302.00 Median $380.19 Typical High $380.19 | Facility | None | $302.00 | $380.19 | $380.19 |
United Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $489.78 | Professional | None | $288.40 | $316.23 | $489.78 |
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 $158.49 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $38.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $407.38 Typical High $407.38 | Professional | RR · Rental | $40.74 | $407.38 | $407.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | UE · Used equipment | $309.03 | $309.03 | $309.03 |
Where Colorado sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 44th of 51
$389
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.