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 $0.41 Median $0.41 Typical High $0.41 | Facility | None | $0.41 | $0.41 | $0.41 |
Aetna Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.68 | Professional | None | $0.41 | $0.41 | $0.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.39 Median $0.42 Typical High $1.62 | Professional | None | $0.39 | $0.42 | $1.62 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Denver HMP Setting Facility Modifier None Typical Low $0.41 Median $0.63 Typical High $1.05 | Facility | None | $0.41 | $0.63 | $1.05 |
Denver HMP Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | None | $0.98 | $0.98 | $0.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.98 Median $1.29 Typical High $1.95 | Professional | None | $0.98 | $1.29 | $1.95 |
Select Health Setting Facility Modifier None Typical Low $0.98 Median $1.78 Typical High $2.04 | Facility | None | $0.98 | $1.78 | $2.04 |
Select Health Setting Professional Modifier None Typical Low $0.85 Median $0.95 Typical High $1.70 | Professional | None | $0.85 | $0.95 | $1.70 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.41 Typical High $0.56 | Professional | None | $0.36 | $0.41 | $0.56 |
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 $0.21 Median $0.21 Typical High $0.34 | Professional | 52 · Reduced service | $0.21 | $0.21 | $0.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.14 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.10 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | RR · Rental | $0.60 | $0.60 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.32 Median $0.38 Typical High $0.72 | Professional | UE · Used equipment | $0.32 | $0.38 | $0.72 |
Where Colorado sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 51st of 51
$0.41
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.