How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $2.69 Median $5.25 Typical High $10.96 | Facility | None | $2.69 | $5.25 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $5.25 | Professional | None | $2.69 | $2.69 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.02 Median $4.57 Typical High $7.94 | Facility | None | $3.02 | $4.57 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Cigna Setting Facility Modifier None Typical Low $2.75 Median $3.02 Typical High $3.80 | Facility | None | $2.75 | $3.02 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Denver HMP Setting Facility Modifier None Typical Low $2.69 Median $2.75 Typical High $3.89 | Facility | None | $2.69 | $2.75 | $3.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.04 Median $2.95 Typical High $5.37 | Professional | None | $2.04 | $2.95 | $5.37 |
Select Health Setting Facility Modifier None Typical Low $2.69 Median $5.01 Typical High $5.62 | Facility | None | $2.69 | $5.01 | $5.62 |
Select Health Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.69 | Professional | None | $1.86 | $1.86 | $2.69 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
4 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 $1.35 Median $1.35 Typical High $2.57 | Professional | 52 · Reduced service | $1.35 | $1.35 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.54 Typical High $1.05 | Professional | 53 · Discontinued | $0.54 | $0.54 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $0.78 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.52 |
Where Colorado sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 5th of 51
$3.31
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.