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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.89 | Professional | None | $3.55 | $3.55 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.63 Typical High $8.32 | Professional | None | $3.09 | $3.63 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Denver HMP Setting Facility Modifier None Typical Low $3.55 Median $5.37 Typical High $9.33 | Facility | None | $3.55 | $5.37 | $9.33 |
Denver HMP Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.32 Median $10.96 Typical High $16.22 | Professional | None | $8.32 | $10.96 | $16.22 |
Select Health Setting Facility Modifier None Typical Low $8.32 Median $15.49 Typical High $17.78 | Facility | None | $8.32 | $15.49 | $17.78 |
Select Health Setting Professional Modifier None Typical Low $7.41 Median $8.32 Typical High $14.79 | Professional | None | $7.41 | $8.32 | $14.79 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $5.01 | Professional | None | $3.16 | $3.47 | $5.01 |
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 $1.78 Median $1.78 Typical High $2.95 | Professional | 52 · Reduced service | $1.78 | $1.78 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $1.17 | Professional | 53 · Discontinued | $0.71 | $0.71 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.87 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | RR · Rental | $5.37 | $5.37 | $5.37 |
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
$3.55
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.