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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | None | $109.65 | $109.65 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $645.65 | Facility | None | $213.80 | $234.42 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $269.15 | Professional | None | $95.50 | $123.03 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Denver HMP Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $275.42 | Facility | None | $66.07 | $125.89 | $275.42 |
Denver HMP Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $446.68 | Professional | None | $162.18 | $288.40 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $407.38 Typical High $467.74 | Facility | None | $223.87 | $407.38 | $467.74 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $275.42 | Professional | None | $154.88 | $223.87 | $275.42 |
United Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $134.90 | Facility | None | $107.15 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $158.49 | Professional | None | $91.20 | $102.33 | $158.49 |
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 $54.95 Median $54.95 Typical High $69.18 | Professional | 52 · Reduced service | $54.95 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $21.88 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $20.42 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $13.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $123.03 Typical High $123.03 | Professional | RR · Rental | $12.30 | $123.03 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | UE · Used equipment | $93.33 | $93.33 | $93.33 |
Where Colorado sits
The same service costs 2.7 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· 47th of 51
$123
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.