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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | None | $39.81 | $39.81 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $234.42 | Facility | None | $77.62 | $87.10 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $53.70 Typical High $114.82 | Professional | None | $33.11 | $53.70 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Denver HMP Setting Facility Modifier None Typical Low $25.70 Median $45.71 Typical High $97.72 | Facility | None | $25.70 | $45.71 | $97.72 |
Denver HMP Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $169.82 | Professional | None | $61.66 | $107.15 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $151.36 Typical High $169.82 | Facility | None | $81.28 | $151.36 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $109.65 | Professional | None | $69.18 | $81.28 | $109.65 |
United Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $64.57 | Facility | None | $53.70 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $61.66 | Professional | None | $36.31 | $39.81 | $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 $19.95 Median $19.95 Typical High $22.91 | Professional | 52 · Reduced service | $19.95 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.12 | Professional | 53 · Discontinued | $7.94 | $7.94 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.92 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $5.25 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | UE · Used equipment | $38.90 | $38.90 | $38.90 |
Where Colorado sits
The same service costs 4.9 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· 43rd of 51
$43.65
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.