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 $1.12 Median $1.12 Typical High $1.12 | Facility | None | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.66 | Professional | None | $1.12 | $1.12 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.38 Typical High $3.39 | Professional | None | $1.29 | $1.38 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.82 | Professional | None | $1.32 | $1.32 | $1.82 |
Denver HMP Setting Facility Modifier None Typical Low $0.71 Median $1.58 Typical High $3.31 | Facility | None | $0.71 | $1.58 | $3.31 |
Denver HMP Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.95 Median $3.47 Typical High $5.25 | Professional | None | $1.95 | $3.47 | $5.25 |
Select Health Setting Facility Modifier None Typical Low $2.63 Median $4.90 Typical High $5.50 | Facility | None | $2.63 | $4.90 | $5.50 |
Select Health Setting Professional Modifier None Typical Low $2.09 Median $2.63 Typical High $3.72 | Professional | None | $2.09 | $2.63 | $3.72 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.10 Typical High $1.66 | Professional | None | $1.00 | $1.10 | $1.66 |
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 $0.56 Median $0.56 Typical High $0.83 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.34 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.25 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | RR · Rental | $1.38 | $1.38 | $1.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.98 Median $0.98 Typical High $1.29 | Professional | UE · Used equipment | $0.98 | $0.98 | $1.29 |
Where Colorado sits
The same service costs 2.3 times more in Kansas 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· 49th of 51
$1.32
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.