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 $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $11.48 | Professional | None | $9.33 | $9.33 | $11.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.62 Median $20.42 Typical High $54.95 | Facility | None | $18.62 | $20.42 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $13.49 Typical High $30.20 | Professional | None | $7.41 | $13.49 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Denver HMP Setting Facility Modifier None Typical Low $6.03 Median $11.75 Typical High $23.99 | Facility | None | $6.03 | $11.75 | $23.99 |
Denver HMP Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.45 Median $25.12 Typical High $38.90 | Professional | None | $14.45 | $25.12 | $38.90 |
Select Health Setting Facility Modifier None Typical Low $19.05 Median $35.48 Typical High $40.74 | Facility | None | $19.05 | $35.48 | $40.74 |
Select Health Setting Professional Modifier None Typical Low $14.79 Median $19.05 Typical High $25.70 | Professional | None | $14.79 | $19.05 | $25.70 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $12.88 | Facility | None | $12.59 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $14.45 | Professional | None | $8.51 | $9.33 | $14.45 |
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 $4.68 Median $4.68 Typical High $5.75 | Professional | 52 · Reduced service | $4.68 | $4.68 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $2.29 | Professional | 53 · Discontinued | $1.91 | $1.91 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.41 Typical High $1.70 | Professional | 55 · Aftercare only | $1.41 | $1.41 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $1.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $14.13 Typical High $14.13 | Professional | RR · Rental | $1.35 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | UE · Used equipment | $10.23 | $10.23 | $10.23 |
Where Colorado sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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
$10.72
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.