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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $14.45 | Professional | None | $11.75 | $11.75 | $14.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $25.12 Typical High $69.18 | Facility | None | $22.91 | $25.12 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $17.78 Typical High $39.81 | Professional | None | $10.00 | $17.78 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Denver HMP Setting Facility Modifier None Typical Low $7.59 Median $13.80 Typical High $29.51 | Facility | None | $7.59 | $13.80 | $29.51 |
Denver HMP Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.78 Median $30.90 Typical High $47.86 | Professional | None | $17.78 | $30.90 | $47.86 |
Select Health Setting Facility Modifier None Typical Low $23.99 Median $43.65 Typical High $50.12 | Facility | None | $23.99 | $43.65 | $50.12 |
Select Health Setting Professional Modifier None Typical Low $16.60 Median $23.99 Typical High $31.62 | Professional | None | $16.60 | $23.99 | $31.62 |
United Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $15.49 | Facility | None | $12.88 | $15.49 | $15.49 |
United Setting Professional Modifier None Typical Low $10.47 Median $11.75 Typical High $17.78 | Professional | None | $10.47 | $11.75 | $17.78 |
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 $5.89 Median $5.89 Typical High $7.24 | Professional | 52 · Reduced service | $5.89 | $5.89 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $2.88 | Professional | 53 · Discontinued | $2.34 | $2.34 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $2.14 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $18.62 Typical High $18.62 | Professional | RR · Rental | $1.82 | $18.62 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | UE · Used equipment | $13.49 | $13.49 | $13.49 |
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
$12.88
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.