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 $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $2.51 | Professional | None | $1.91 | $1.91 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.62 Median $2.24 Typical High $5.89 | Professional | None | $1.62 | $2.24 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $3.31 | Professional | None | $2.29 | $2.29 | $3.31 |
Denver HMP Setting Facility Modifier None Typical Low $1.23 Median $2.75 Typical High $5.62 | Facility | None | $1.23 | $2.75 | $5.62 |
Denver HMP Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.16 Median $5.75 Typical High $9.33 | Professional | None | $3.16 | $5.75 | $9.33 |
Select Health Setting Facility Modifier None Typical Low $4.57 Median $8.32 Typical High $9.55 | Facility | None | $4.57 | $8.32 | $9.55 |
Select Health Setting Professional Modifier None Typical Low $3.16 Median $4.57 Typical High $6.31 | Professional | None | $3.16 | $4.57 | $6.31 |
United Setting Professional Modifier None Typical Low $1.62 Median $1.91 Typical High $2.82 | Professional | None | $1.62 | $1.91 | $2.82 |
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 $0.95 Median $0.95 Typical High $1.29 | Professional | 52 · Reduced service | $0.95 | $0.95 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.38 Typical High $0.51 | Professional | 53 · Discontinued | $0.38 | $0.38 | $0.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.38 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $2.24 Typical High $2.24 | Professional | RR · Rental | $0.23 | $2.24 | $2.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | UE · Used equipment | $1.70 | $1.70 | $1.70 |
Where Colorado sits
The same service costs 2.1 times more in Montana than in New Hampshire. 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· 44th of 51
$2.29
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.