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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | None | $131.83 | $131.83 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $281.84 Typical High $776.25 | Facility | None | $257.04 | $281.84 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $302.00 | Professional | None | $91.20 | $138.04 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $141.25 Typical High $302.00 | Facility | None | $72.44 | $141.25 | $302.00 |
Denver HMP Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $537.03 | Professional | None | $194.98 | $346.74 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $501.19 Typical High $562.34 | Facility | None | $269.15 | $501.19 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $338.84 | Professional | None | $190.55 | $269.15 | $338.84 |
United Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $131.83 | Facility | None | $107.15 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $173.78 | Professional | None | $100.00 | $112.20 | $173.78 |
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 $66.07 Median $66.07 Typical High $67.61 | Professional | 52 · Reduced service | $66.07 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.92 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $138.04 Typical High $138.04 | Professional | RR · Rental | $13.80 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | UE · Used equipment | $102.33 | $102.33 | $102.33 |
Where Colorado sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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· 39th of 51
$132
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.