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 $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.62 | Professional | None | $1.10 | $1.10 | $1.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.07 Median $1.26 Typical High $3.31 | Professional | None | $1.07 | $1.26 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.78 | Professional | None | $1.45 | $1.45 | $1.78 |
Denver HMP Setting Facility Modifier None Typical Low $0.69 Median $1.55 Typical High $3.24 | Facility | None | $0.69 | $1.55 | $3.24 |
Denver HMP Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | None | $0.69 | $0.69 | $0.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.95 Median $3.39 Typical High $5.13 | Professional | None | $1.95 | $3.39 | $5.13 |
Select Health Setting Facility Modifier None Typical Low $2.57 Median $4.79 Typical High $5.37 | Facility | None | $2.57 | $4.79 | $5.37 |
Select Health Setting Professional Modifier None Typical Low $2.04 Median $2.57 Typical High $3.63 | Professional | None | $2.04 | $2.57 | $3.63 |
United Setting Professional Modifier None Typical Low $0.98 Median $1.07 Typical High $1.62 | Professional | None | $0.98 | $1.07 | $1.62 |
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 $0.55 Median $0.55 Typical High $0.81 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.33 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.25 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.16 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $1.26 Typical High $1.26 | Professional | RR · Rental | $0.13 | $1.26 | $1.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | UE · Used equipment | $0.95 | $0.95 | $0.95 |
Where Colorado sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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
$1.45
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.