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 $0.76 Median $1.00 Typical High $2.95 | Facility | None | $0.76 | $1.00 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.81 Typical High $1.41 | Professional | None | $0.76 | $0.81 | $1.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.83 Median $1.29 Typical High $2.24 | Facility | None | $0.83 | $1.29 | $2.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Cigna Setting Facility Modifier None Typical Low $0.74 Median $0.85 Typical High $1.20 | Facility | None | $0.74 | $0.85 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Denver HMP Setting Facility Modifier None Typical Low $0.76 Median $0.95 Typical High $1.12 | Facility | None | $0.76 | $0.95 | $1.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.56 Median $0.83 Typical High $1.51 | Professional | None | $0.56 | $0.83 | $1.51 |
Select Health Setting Facility Modifier None Typical Low $0.76 Median $1.38 Typical High $1.58 | Facility | None | $0.76 | $1.38 | $1.58 |
Select Health Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.76 | Professional | None | $0.52 | $0.52 | $0.76 |
United Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $0.78 | Professional | None | $0.69 | $0.69 | $0.78 |
3 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 $0.38 Median $0.38 Typical High $0.69 | Professional | 52 · Reduced service | $0.38 | $0.38 | $0.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.28 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.21 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.21 |
Where Colorado sits
The same service costs 5.2 times more in Vermont 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· 10th of 51
$0.93
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.