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 $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $4.27 | Professional | None | $2.88 | $2.88 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $3.55 Typical High $8.71 | Professional | None | $2.69 | $3.55 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.68 | Professional | None | $3.39 | $3.39 | $4.68 |
Denver HMP Setting Facility Modifier None Typical Low $1.82 Median $4.07 Typical High $8.51 | Facility | None | $1.82 | $4.07 | $8.51 |
Denver HMP Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $8.71 Typical High $13.49 | Professional | None | $5.01 | $8.71 | $13.49 |
Select Health Setting Facility Modifier None Typical Low $6.76 Median $12.59 Typical High $14.13 | Facility | None | $6.76 | $12.59 | $14.13 |
Select Health Setting Professional Modifier None Typical Low $5.37 Median $6.76 Typical High $9.55 | Professional | None | $5.37 | $6.76 | $9.55 |
United Setting Professional Modifier None Typical Low $2.51 Median $2.82 Typical High $4.27 | Professional | None | $2.51 | $2.82 | $4.27 |
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 $1.45 Median $1.45 Typical High $2.14 | Professional | 52 · Reduced service | $1.45 | $1.45 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $0.85 | Professional | 53 · Discontinued | $0.56 | $0.56 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.65 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.43 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.47 Median $3.55 Typical High $3.55 | Professional | RR · Rental | $0.47 | $3.55 | $3.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.51 Median $2.51 Typical High $3.31 | Professional | UE · Used equipment | $2.51 | $2.51 | $3.31 |
Where Colorado sits
The same service costs 2.1 times more in Kansas than in Alabama. 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
$3.39
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.