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 $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $3.47 | Professional | None | $2.04 | $2.04 | $3.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.86 Typical High $4.90 | Professional | None | $1.82 | $1.86 | $4.90 |
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 $2.04 Median $3.09 Typical High $5.37 | Facility | None | $2.04 | $3.09 | $5.37 |
Denver HMP Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $6.46 Typical High $9.77 | Professional | None | $4.90 | $6.46 | $9.77 |
Select Health Setting Facility Modifier None Typical Low $4.90 Median $8.91 Typical High $10.23 | Facility | None | $4.90 | $8.91 | $10.23 |
Select Health Setting Professional Modifier None Typical Low $4.27 Median $4.79 Typical High $8.51 | Professional | None | $4.27 | $4.79 | $8.51 |
United Setting Professional Modifier None Typical Low $1.82 Median $2.04 Typical High $2.88 | Professional | None | $1.82 | $2.04 | $2.88 |
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 $1.02 Median $1.02 Typical High $1.70 | Professional | 52 · Reduced service | $1.02 | $1.02 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.41 Typical High $0.68 | Professional | 53 · Discontinued | $0.41 | $0.41 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.31 Typical High $0.51 | Professional | 55 · Aftercare only | $0.31 | $0.31 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.34 |
Where Colorado sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 45th of 51
$2.04
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.