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 $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $7.76 | Professional | None | $5.13 | $5.13 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $6.31 Typical High $15.85 | Professional | None | $5.01 | $6.31 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $8.32 | Professional | None | $6.03 | $6.03 | $8.32 |
Denver HMP Setting Facility Modifier None Typical Low $3.24 Median $7.24 Typical High $15.14 | Facility | None | $3.24 | $7.24 | $15.14 |
Denver HMP Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.91 Median $15.85 Typical High $24.55 | Professional | None | $8.91 | $15.85 | $24.55 |
Select Health Setting Facility Modifier None Typical Low $12.02 Median $22.39 Typical High $25.70 | Facility | None | $12.02 | $22.39 | $25.70 |
Select Health Setting Professional Modifier None Typical Low $9.77 Median $12.02 Typical High $16.98 | Professional | None | $9.77 | $12.02 | $16.98 |
United Setting Professional Modifier None Typical Low $4.57 Median $5.01 Typical High $7.59 | Professional | None | $4.57 | $5.01 | $7.59 |
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 $2.57 Median $2.57 Typical High $3.89 | Professional | 52 · Reduced service | $2.57 | $2.57 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.02 Typical High $1.55 | Professional | 53 · Discontinued | $1.02 | $1.02 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $1.15 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.83 Median $6.31 Typical High $6.31 | Professional | RR · Rental | $0.83 | $6.31 | $6.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | UE · Used equipment | $4.47 | $4.47 | $5.62 |
Where Colorado sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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
$6.03
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.