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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | None | $416.87 | $416.87 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $891.25 Typical High $2,398.83 | Facility | None | $812.83 | $891.25 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $1,174.90 | Professional | None | $389.05 | $501.19 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None | $512.86 | $512.86 | $691.83 |
Denver HMP Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $1,047.13 | Facility | None | $263.03 | $489.78 | $1,047.13 |
Denver HMP Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,698.24 | Professional | None | $588.84 | $1,096.48 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $1,548.82 Typical High $1,778.28 | Facility | None | $851.14 | $1,548.82 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,122.02 | Professional | None | $724.44 | $851.14 | $1,122.02 |
United Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Facility | None | $398.11 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $630.96 | Professional | None | $371.54 | $407.38 | $630.96 |
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 $204.17 Median $204.17 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $501.19 Typical High $501.19 | Professional | RR · Rental | $50.12 | $501.19 | $501.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | UE · Used equipment | $380.19 | $380.19 | $380.19 |
Where Colorado sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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· 40th of 51
$513
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.