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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.27 | Professional | None | $0.15 | $0.15 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.04 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.40 | Professional | None | $0.26 | $0.26 | $0.40 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Denver HMP Setting Facility Modifier None Typical Low $0.15 Median $0.21 Typical High $0.52 | Facility | None | $0.15 | $0.21 | $0.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $346.74 | Professional | None | $1.00 | $1.00 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.83 | Professional | None | $0.71 | $0.71 | $0.83 |
United Setting Professional Modifier None Typical Low $0.20 Median $0.22 Typical High $0.36 | Professional | None | $0.20 | $0.22 | $0.36 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.20 Median $0.22 Typical High $0.28 | Professional | UE · Used equipment | $0.20 | $0.22 | $0.28 |
Where Colorado sits
The same service costs 15.5 times more in Minnesota than in Hawaii. 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
$0.22
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.