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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $239.88 | Professional | None | $177.83 | $213.80 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $457.09 Typical High $1,258.93 | Facility | None | $416.87 | $457.09 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $524.81 | Professional | None | $165.96 | $288.40 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $302.00 | Facility | None | $295.12 | $295.12 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $302.00 | Professional | None | $213.80 | $213.80 | $302.00 |
Denver HMP Setting Facility Modifier None Typical Low $123.03 Median $239.88 Typical High $524.81 | Facility | None | $123.03 | $239.88 | $524.81 |
Denver HMP Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $831.76 | Professional | None | $323.59 | $549.54 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $812.83 Typical High $912.01 | Facility | None | $436.52 | $812.83 | $912.01 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $549.54 | Professional | None | $302.00 | $436.52 | $549.54 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $302.00 | Professional | None | $169.82 | $190.55 | $302.00 |
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 $107.15 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $34.67 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $22.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $295.12 Typical High $295.12 | Professional | RR · Rental | $27.54 | $295.12 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | UE · Used equipment | $208.93 | $208.93 | $208.93 |
Where Colorado sits
The same service costs 2.5 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
$214
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.