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 $0.78 Median $0.78 Typical High $0.78 | Facility | None | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $1.17 | Professional | None | $0.78 | $0.78 | $1.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.78 Median $0.95 Typical High $2.40 | Professional | None | $0.78 | $0.95 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.29 | Professional | None | $0.93 | $0.93 | $1.29 |
Denver HMP Setting Facility Modifier None Typical Low $0.50 Median $1.10 Typical High $2.29 | Facility | None | $0.50 | $1.10 | $2.29 |
Denver HMP Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | None | $0.50 | $0.50 | $0.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.35 Median $2.40 Typical High $3.72 | Professional | None | $1.35 | $2.40 | $3.72 |
Select Health Setting Facility Modifier None Typical Low $1.82 Median $3.39 Typical High $3.89 | Facility | None | $1.82 | $3.39 | $3.89 |
Select Health Setting Professional Modifier None Typical Low $1.48 Median $1.82 Typical High $2.57 | Professional | None | $1.48 | $1.82 | $2.57 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.78 Typical High $1.15 | Professional | None | $0.71 | $0.78 | $1.15 |
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 $0.39 Median $0.39 Typical High $0.59 | Professional | 52 · Reduced service | $0.39 | $0.39 | $0.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.23 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.18 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | RR · Rental | $0.95 | $0.95 | $0.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.68 Median $0.68 Typical High $0.91 | Professional | UE · Used equipment | $0.68 | $0.68 | $0.91 |
Where Colorado sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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
$0.93
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.