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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | None | $44.67 | $44.67 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $95.50 Typical High $263.03 | Facility | None | $87.10 | $95.50 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $117.49 | Professional | None | $35.48 | $48.98 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Denver HMP Setting Facility Modifier None Typical Low $25.12 Median $50.12 Typical High $107.15 | Facility | None | $25.12 | $50.12 | $107.15 |
Denver HMP Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $181.97 | Professional | None | $67.61 | $117.49 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $165.96 Typical High $190.55 | Facility | None | $91.20 | $165.96 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $125.89 | Professional | None | $63.10 | $91.20 | $125.89 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $60.26 | Professional | None | $35.48 | $38.90 | $60.26 |
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 $22.39 Median $22.39 Typical High $23.44 | Professional | 52 · Reduced service | $22.39 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 53 · Discontinued | $8.91 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $7.08 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $48.98 Typical High $48.98 | Professional | RR · Rental | $4.79 | $48.98 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | UE · Used equipment | $35.48 | $35.48 | $35.48 |
Where Colorado sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 28th of 51
$58.88
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.