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 $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $4.17 | Professional | None | $2.82 | $2.82 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $11.22 | Professional | None | $3.24 | $3.39 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.17 | Facility | None | $3.89 | $3.89 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.57 | Professional | None | $3.31 | $3.31 | $4.57 |
Denver HMP Setting Facility Modifier None Typical Low $2.82 Median $4.07 Typical High $8.32 | Facility | None | $2.82 | $4.07 | $8.32 |
Denver HMP Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $8.71 Typical High $14.13 | Professional | None | $4.90 | $8.71 | $14.13 |
Select Health Setting Facility Modifier None Typical Low $6.61 Median $12.30 Typical High $14.13 | Facility | None | $6.61 | $12.30 | $14.13 |
Select Health Setting Professional Modifier None Typical Low $5.37 Median $6.61 Typical High $9.33 | Professional | None | $5.37 | $6.61 | $9.33 |
United Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $4.27 | Professional | None | $2.51 | $2.75 | $4.27 |
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 $1.41 Median $1.41 Typical High $2.14 | Professional | 52 · Reduced service | $1.41 | $1.41 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $0.85 | Professional | 53 · Discontinued | $0.56 | $0.56 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $0.63 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.46 Median $3.39 Typical High $3.39 | Professional | RR · Rental | $0.46 | $3.39 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $2.40 Typical High $2.57 | Professional | UE · Used equipment | $2.40 | $2.40 | $2.57 |
Where Colorado sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$3.31
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.