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 $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.45 | Professional | None | $1.00 | $1.00 | $1.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.87 Median $1.23 Typical High $3.09 | Professional | None | $0.87 | $1.23 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.74 | Facility | None | $1.41 | $1.41 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.74 | Professional | None | $1.20 | $1.20 | $1.74 |
Denver HMP Setting Facility Modifier None Typical Low $0.65 Median $1.45 Typical High $3.02 | Facility | None | $0.65 | $1.45 | $3.02 |
Denver HMP Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.78 Median $3.09 Typical High $5.01 | Professional | None | $1.78 | $3.09 | $5.01 |
Select Health Setting Facility Modifier None Typical Low $2.40 Median $4.47 Typical High $5.01 | Facility | None | $2.40 | $4.47 | $5.01 |
Select Health Setting Professional Modifier None Typical Low $1.86 Median $2.40 Typical High $3.39 | Professional | None | $1.86 | $2.40 | $3.39 |
United Setting Professional Modifier None Typical Low $0.89 Median $1.00 Typical High $1.51 | Professional | None | $0.89 | $1.00 | $1.51 |
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 $0.15 Median $0.15 Typical High $0.23 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | RR · Rental | $1.26 | $1.26 | $1.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.89 Median $0.89 Typical High $1.02 | Professional | UE · Used equipment | $0.89 | $0.89 | $1.02 |
Where Colorado sits
The same service costs 5.4 times more in Kansas 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· 44th of 51
$1.20
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.