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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $14.79 | Professional | None | $13.18 | $13.18 | $14.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $28.18 Typical High $77.62 | Facility | None | $25.70 | $28.18 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $15.85 Typical High $33.88 | Professional | None | $10.00 | $15.85 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Denver HMP Setting Facility Modifier None Typical Low $7.94 Median $15.49 Typical High $30.90 | Facility | None | $7.94 | $15.49 | $30.90 |
Denver HMP Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.95 Median $34.67 Typical High $56.23 | Professional | None | $19.95 | $34.67 | $56.23 |
Select Health Setting Facility Modifier None Typical Low $26.92 Median $50.12 Typical High $56.23 | Facility | None | $26.92 | $50.12 | $56.23 |
Select Health Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $33.88 | Professional | None | $20.89 | $26.92 | $33.88 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $16.22 | Facility | None | $12.88 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $11.22 Median $12.30 Typical High $19.05 | Professional | None | $11.22 | $12.30 | $19.05 |
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 $6.61 Median $6.61 Typical High $7.41 | Professional | 52 · Reduced service | $6.61 | $6.61 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $2.95 | Professional | 53 · Discontinued | $2.63 | $2.63 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.19 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $15.85 Typical High $15.85 | Professional | RR · Rental | $1.55 | $15.85 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | UE · Used equipment | $11.48 | $11.48 | $11.48 |
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· 49th of 51
$13.18
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.