How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1.20 Median $1.86 Typical High $6.31 | Facility | None | $1.20 | $1.86 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $1.86 Typical High $2.14 | Professional | None | $1.20 | $1.86 | $2.14 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $1.05 Typical High $4.37 | Professional | None | $0.89 | $1.05 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Denver HMP Setting Facility Modifier None Typical Low $1.86 Median $2.82 Typical High $4.90 | Facility | None | $1.86 | $2.82 | $4.90 |
Denver HMP Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.47 Median $5.89 Typical High $8.91 | Professional | None | $4.47 | $5.89 | $8.91 |
Kaiser Permanente Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.47 Median $5.89 Typical High $8.51 | Professional | AU · Urologic/ostomy supply | $4.47 | $5.89 | $8.51 |
Select Health Setting Facility Modifier None Typical Low $4.47 Median $8.32 Typical High $9.33 | Facility | None | $4.47 | $8.32 | $9.33 |
Select Health Setting Professional Modifier None Typical Low $2.34 Median $4.17 Typical High $7.76 | Professional | None | $2.34 | $4.17 | $7.76 |
United Setting Professional Modifier None Typical Low $1.70 Median $1.86 Typical High $2.63 | Professional | None | $1.70 | $1.86 | $2.63 |
4 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 $0.93 Median $0.93 Typical High $1.55 | Professional | 52 · Reduced service | $0.93 | $0.93 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.38 Typical High $0.62 | Professional | 53 · Discontinued | $0.38 | $0.38 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.46 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.31 |
Where Colorado sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 46th of 51
$1.86
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.