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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | None | $57.54 | $57.54 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $338.84 | Facility | None | $112.20 | $123.03 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $151.36 | Professional | None | $45.71 | $61.66 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Denver HMP Setting Facility Modifier None Typical Low $33.11 Median $64.57 Typical High $138.04 | Facility | None | $33.11 | $64.57 | $138.04 |
Denver HMP Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $239.88 | Professional | None | $87.10 | $151.36 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $218.78 Typical High $245.47 | Facility | None | $117.49 | $218.78 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $165.96 | Professional | None | $81.28 | $117.49 | $165.96 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $77.62 | Professional | None | $45.71 | $51.29 | $77.62 |
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 $28.84 Median $28.84 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $61.66 Typical High $61.66 | Professional | RR · Rental | $6.17 | $61.66 | $61.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Where Colorado sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 33rd of 51
$75.86
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.