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 $1.05 Median $1.05 Typical High $2.29 | Facility | None | $1.05 | $1.05 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.78 | Professional | None | $1.05 | $1.05 | $1.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.85 Median $1.10 Typical High $4.27 | Professional | None | $0.85 | $1.10 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Denver HMP Setting Facility Modifier None Typical Low $1.05 Median $1.62 Typical High $2.75 | Facility | None | $1.05 | $1.62 | $2.75 |
Denver HMP Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.51 Median $3.31 Typical High $4.79 | Professional | None | $2.51 | $3.31 | $4.79 |
Select Health Setting Facility Modifier None Typical Low $2.51 Median $4.68 Typical High $5.25 | Facility | None | $2.51 | $4.68 | $5.25 |
Select Health Setting Professional Modifier None Typical Low $2.19 Median $2.45 Typical High $4.37 | Professional | None | $2.19 | $2.45 | $4.37 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.05 Typical High $1.48 | Professional | None | $0.93 | $1.05 | $1.48 |
5 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 $0.52 Median $0.52 Typical High $0.87 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.35 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.26 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | RR · Rental | $1.58 | $1.58 | $1.58 |
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
$1.05
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.