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 $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $2.14 Typical High $3.09 | Professional | None | $1.58 | $2.14 | $3.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.69 Typical High $6.61 | Professional | None | $2.14 | $2.69 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.55 | Professional | None | $2.57 | $2.57 | $3.55 |
Denver HMP Setting Facility Modifier None Typical Low $1.38 Median $3.09 Typical High $6.31 | Facility | None | $1.38 | $3.09 | $6.31 |
Denver HMP Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.72 Median $6.61 Typical High $10.23 | Professional | None | $3.72 | $6.61 | $10.23 |
Select Health Setting Facility Modifier None Typical Low $5.13 Median $9.33 Typical High $10.72 | Facility | None | $5.13 | $9.33 | $10.72 |
Select Health Setting Professional Modifier None Typical Low $4.07 Median $5.13 Typical High $7.08 | Professional | None | $4.07 | $5.13 | $7.08 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.14 Typical High $3.24 | Professional | None | $1.91 | $2.14 | $3.24 |
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 $1.07 Median $1.07 Typical High $1.62 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.65 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.49 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.33 Median $2.63 Typical High $2.63 | Professional | RR · Rental | $0.33 | $2.63 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $1.86 Typical High $2.51 | Professional | UE · Used equipment | $1.86 | $1.86 | $2.51 |
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· 46th of 51
$2.57
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.