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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $18.20 | Professional | None | $15.85 | $15.85 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $37.15 Typical High $93.33 | Facility | None | $31.62 | $37.15 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $25.12 Typical High $41.69 | Professional | None | $12.88 | $25.12 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $28.84 | Professional | None | $21.38 | $21.38 | $28.84 |
Denver HMP Setting Facility Modifier None Typical Low $9.12 Median $18.20 Typical High $38.90 | Facility | None | $9.12 | $18.20 | $38.90 |
Denver HMP Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $42.66 Typical High $69.18 | Professional | None | $24.55 | $42.66 | $69.18 |
Select Health Setting Facility Modifier None Typical Low $32.36 Median $60.26 Typical High $69.18 | Facility | None | $32.36 | $60.26 | $69.18 |
Select Health Setting Professional Modifier None Typical Low $22.91 Median $32.36 Typical High $45.71 | Professional | None | $22.91 | $32.36 | $45.71 |
United Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
United Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $21.88 | Professional | None | $12.88 | $14.13 | $21.88 |
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 $7.94 Median $7.94 Typical High $8.51 | Professional | 52 · Reduced service | $7.94 | $7.94 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.39 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.51 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $1.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $25.12 Typical High $25.12 | Professional | RR · Rental | $2.51 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | UE · Used equipment | $18.62 | $18.62 | $18.62 |
Where Colorado sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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
$21.38
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.