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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | None | $45.71 | $45.71 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $100.00 Typical High $269.15 | Facility | None | $89.13 | $100.00 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $120.23 | Professional | None | $36.31 | $54.95 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Denver HMP Setting Facility Modifier None Typical Low $26.30 Median $51.29 Typical High $109.65 | Facility | None | $26.30 | $51.29 | $109.65 |
Denver HMP Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $194.98 | Professional | None | $70.79 | $123.03 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $173.78 Typical High $194.98 | Facility | None | $93.33 | $173.78 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $131.83 | Professional | None | $66.07 | $93.33 | $131.83 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $131.83 | Facility | None | $44.67 | $44.67 | $131.83 |
United Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $61.66 | Professional | None | $36.31 | $40.74 | $61.66 |
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 $22.91 Median $22.91 Typical High $24.55 | Professional | 52 · Reduced service | $22.91 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.77 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $7.24 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $54.95 Typical High $54.95 | Professional | RR · Rental | $5.50 | $54.95 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Where Colorado sits
The same service costs 2.8 times more in Kansas 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
$45.71
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.