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 $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $7.76 | Professional | None | $5.37 | $5.37 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $5.37 Typical High $14.79 | Professional | None | $4.57 | $5.37 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.89 | Professional | None | $5.01 | $5.13 | $5.89 |
Denver HMP Setting Facility Modifier None Typical Low $3.39 Median $7.59 Typical High $15.85 | Facility | None | $3.39 | $7.59 | $15.85 |
Denver HMP Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.55 Median $16.60 Typical High $25.70 | Professional | None | $9.55 | $16.60 | $25.70 |
Select Health Setting Facility Modifier None Typical Low $12.59 Median $23.44 Typical High $26.92 | Facility | None | $12.59 | $23.44 | $26.92 |
Select Health Setting Professional Modifier None Typical Low $8.91 Median $12.59 Typical High $17.78 | Professional | None | $8.91 | $12.59 | $17.78 |
United Setting Professional Modifier None Typical Low $4.47 Median $5.25 Typical High $7.94 | Professional | None | $4.47 | $5.25 | $7.94 |
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 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $1.15 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $0.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.54 Median $5.37 Typical High $5.37 | Professional | RR · Rental | $0.54 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | UE · Used equipment | $3.98 | $3.98 | $3.98 |
Where Colorado sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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· 43rd of 51
$5.37
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.