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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Professional | None | $64.57 | $64.57 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $138.04 Typical High $380.19 | Facility | None | $125.89 | $138.04 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $169.82 Typical High $331.13 | Professional | None | $51.29 | $169.82 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
Denver HMP Setting Facility Modifier None Typical Low $36.31 Median $72.44 Typical High $154.88 | Facility | None | $36.31 | $72.44 | $154.88 |
Denver HMP Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $269.15 | Professional | None | $97.72 | $169.82 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $239.88 Typical High $275.42 | Facility | None | $131.83 | $239.88 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $181.97 | Professional | None | $91.20 | $131.83 | $181.97 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $87.10 | Professional | None | $51.29 | $56.23 | $87.10 |
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 $32.36 Median $32.36 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $10.23 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $331.13 Typical High $331.13 | Professional | RR · Rental | $33.11 | $331.13 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | UE · Used equipment | $251.19 | $251.19 | $251.19 |
Where Colorado sits
The same service costs 2.4 times more in Indiana than in Kentucky. 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· 37th of 51
$85.11
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.