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 $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $5.89 | Professional | None | $3.89 | $3.89 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.89 Median $4.79 Typical High $12.02 | Professional | None | $3.89 | $4.79 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.46 | Professional | None | $4.68 | $4.68 | $6.46 |
Denver HMP Setting Facility Modifier None Typical Low $2.51 Median $5.62 Typical High $11.48 | Facility | None | $2.51 | $5.62 | $11.48 |
Denver HMP Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.76 Median $12.02 Typical High $18.62 | Professional | None | $6.76 | $12.02 | $18.62 |
Select Health Setting Facility Modifier None Typical Low $9.33 Median $17.38 Typical High $19.50 | Facility | None | $9.33 | $17.38 | $19.50 |
Select Health Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $12.88 | Professional | None | $7.41 | $9.33 | $12.88 |
United Setting Professional Modifier None Typical Low $3.47 Median $3.89 Typical High $5.75 | Professional | None | $3.47 | $3.89 | $5.75 |
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 $1.95 Median $1.95 Typical High $2.95 | Professional | 52 · Reduced service | $1.95 | $1.95 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $1.17 | Professional | 53 · Discontinued | $0.78 | $0.78 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $0.89 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $0.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.65 Median $4.79 Typical High $4.79 | Professional | RR · Rental | $0.65 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.39 Median $3.39 Typical High $4.57 | Professional | UE · Used equipment | $3.39 | $3.39 | $4.57 |
Where Colorado sits
The same service costs 2.3 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· 48th of 51
$4.68
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.