How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.27 | Professional | None | $4.07 | $4.07 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $15.49 Typical High $33.11 | Professional | None | $4.27 | $15.49 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Denver HMP Setting Facility Modifier None Typical Low $4.07 Median $4.68 Typical High $7.24 | Facility | None | $4.07 | $4.68 | $7.24 |
Denver HMP Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $52.48 | Professional | None | $25.70 | $36.31 | $52.48 |
Select Health Setting Facility Modifier None Typical Low $27.54 Median $50.12 Typical High $57.54 | Facility | None | $27.54 | $50.12 | $57.54 |
Select Health Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $47.86 | Professional | None | $23.99 | $26.92 | $47.86 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $19.95 | Professional | None | $12.02 | $12.02 | $19.95 |
4 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 $2.04 Median $2.04 Typical High $2.14 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $0.85 | Professional | 53 · Discontinued | $0.81 | $0.81 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.65 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.43 |
Where Colorado sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 40th of 51
$12.02
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.