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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $812.83 Typical High $2,187.76 | Facility | None | $741.31 | $812.83 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $1,202.26 | Professional | None | $363.08 | $457.09 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $436.52 Typical High $954.99 | Facility | None | $239.88 | $436.52 | $954.99 |
Denver HMP Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,513.56 | Professional | None | $537.03 | $1,000.00 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $1,621.81 | Facility | None | $758.58 | $1,412.54 | $1,621.81 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $977.24 | Professional | None | $575.44 | $758.58 | $977.24 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,230.27 | Facility | None | $489.78 | $489.78 | $1,230.27 |
United Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $575.44 | Professional | None | $338.84 | $371.54 | $575.44 |
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 $186.21 Median $186.21 Typical High $257.04 | Professional | 52 · Reduced service | $186.21 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | 53 · Discontinued | $75.86 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $457.09 Typical High $457.09 | Professional | RR · Rental | $45.71 | $457.09 | $457.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | UE · Used equipment | $346.74 | $346.74 | $346.74 |
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· 43rd of 51
$468
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.