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 $22.39 Median $22.39 Typical High $35.48 | Facility | None | $22.39 | $22.39 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $28.18 | Professional | None | $21.88 | $22.39 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $48.98 Typical High $131.83 | Facility | None | $44.67 | $48.98 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $34.67 Typical High $69.18 | Professional | None | $19.95 | $34.67 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $34.67 | Facility | None | $30.20 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Denver HMP Setting Facility Modifier None Typical Low $14.13 Median $26.30 Typical High $57.54 | Facility | None | $14.13 | $26.30 | $57.54 |
Denver HMP Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $34.67 Median $60.26 Typical High $91.20 | Professional | None | $34.67 | $60.26 | $91.20 |
Select Health Setting Facility Modifier None Typical Low $45.71 Median $85.11 Typical High $97.72 | Facility | None | $45.71 | $85.11 | $97.72 |
Select Health Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $60.26 | Professional | None | $33.11 | $45.71 | $60.26 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $35.48 | Professional | None | $19.95 | $21.88 | $35.48 |
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 $11.22 Median $11.22 Typical High $13.80 | Professional | 52 · Reduced service | $11.22 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | 53 · Discontinued | $4.47 | $4.47 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $4.17 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $2.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $40.74 Typical High $40.74 | Professional | RR · Rental | $3.24 | $40.74 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | UE · Used equipment | $24.55 | $24.55 | $24.55 |
Where Colorado sits
The same service costs 3.2 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· 48th of 51
$25.70
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.