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 $1.45 Median $1.45 Typical High $1.45 | Facility | None | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $2.45 | Professional | None | $1.45 | $1.45 | $2.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $1.86 Typical High $3.47 | Professional | None | $1.74 | $1.86 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Denver HMP Setting Facility Modifier None Typical Low $1.45 Median $2.09 Typical High $3.47 | Facility | None | $1.45 | $2.09 | $3.47 |
Denver HMP Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.47 Median $4.57 Typical High $6.76 | Professional | None | $3.47 | $4.57 | $6.76 |
Select Health Setting Facility Modifier None Typical Low $3.47 Median $6.46 Typical High $7.24 | Facility | None | $3.47 | $6.46 | $7.24 |
Select Health Setting Professional Modifier None Typical Low $3.16 Median $3.55 Typical High $6.03 | Professional | None | $3.16 | $3.55 | $6.03 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.70 Typical High $2.57 | Professional | None | $1.55 | $1.70 | $2.57 |
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 $0.72 Median $0.72 Typical High $1.23 | Professional | 52 · Reduced service | $0.72 | $0.72 | $1.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.49 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.22 Typical High $0.36 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.24 |
Where Colorado sits
The same service costs 2.3 times more in Hawaii 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· 49th of 51
$1.70
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.