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 $0.34 Median $0.34 Typical High $0.34 | Facility | None | $0.34 | $0.34 | $0.34 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.55 | Professional | None | $0.34 | $0.34 | $0.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.33 Median $0.38 Typical High $1.35 | Professional | None | $0.33 | $0.38 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Denver HMP Setting Facility Modifier None Typical Low $0.34 Median $0.51 Typical High $0.89 | Facility | None | $0.34 | $0.51 | $0.89 |
Denver HMP Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.79 Median $1.07 Typical High $1.55 | Professional | None | $0.79 | $1.07 | $1.55 |
Select Health Setting Facility Modifier None Typical Low $0.79 Median $1.48 Typical High $1.70 | Facility | None | $0.79 | $1.48 | $1.70 |
Select Health Setting Professional Modifier None Typical Low $0.71 Median $0.78 Typical High $1.41 | Professional | None | $0.71 | $0.78 | $1.41 |
United Setting Professional Modifier None Typical Low $0.30 Median $0.33 Typical High $0.48 | Professional | None | $0.30 | $0.33 | $0.48 |
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 $0.17 Median $0.17 Typical High $0.28 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.11 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.08 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.06 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | RR · Rental | $0.50 | $0.50 | $0.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.28 Median $0.33 Typical High $0.60 | Professional | UE · Used equipment | $0.28 | $0.33 | $0.60 |
Where Colorado sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 50th of 51
$0.34
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.