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 $0.47 Median $0.47 Typical High $0.47 | Facility | None | $0.47 | $0.47 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.79 | Professional | None | $0.47 | $0.47 | $0.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.45 Median $0.48 Typical High $1.86 | Professional | None | $0.45 | $0.48 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Denver HMP Setting Facility Modifier None Typical Low $0.47 Median $0.72 Typical High $1.23 | Facility | None | $0.47 | $0.72 | $1.23 |
Denver HMP Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.07 Median $1.48 Typical High $2.14 | Professional | None | $1.07 | $1.48 | $2.14 |
Select Health Setting Facility Modifier None Typical Low $1.12 Median $2.04 Typical High $2.34 | Facility | None | $1.12 | $2.04 | $2.34 |
Select Health Setting Professional Modifier None Typical Low $1.00 Median $1.10 Typical High $1.95 | Professional | None | $1.00 | $1.10 | $1.95 |
United Setting Professional Modifier None Typical Low $0.41 Median $0.46 Typical High $0.65 | Professional | None | $0.41 | $0.46 | $0.65 |
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 $0.24 Median $0.24 Typical High $0.39 | Professional | 52 · Reduced service | $0.24 | $0.24 | $0.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.16 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.12 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | RR · Rental | $0.69 | $0.69 | $0.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.36 Median $0.40 Typical High $0.68 | Professional | UE · Used equipment | $0.36 | $0.40 | $0.68 |
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
$0.47
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.