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 $6.76 Median $10.72 Typical High $30.90 | Facility | None | $6.76 | $10.72 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $10.00 | Professional | None | $6.76 | $6.76 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.59 Median $11.48 Typical High $19.95 | Facility | None | $7.59 | $11.48 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $7.59 Typical High $16.98 | Facility | None | $6.92 | $7.59 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Denver HMP Setting Facility Modifier None Typical Low $6.76 Median $8.91 Typical High $40.74 | Facility | None | $6.76 | $8.91 | $40.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $7.41 Typical High $10.96 | Professional | None | $5.01 | $7.41 | $10.96 |
Select Health Setting Facility Modifier None Typical Low $6.76 Median $12.59 Typical High $14.13 | Facility | None | $6.76 | $12.59 | $14.13 |
Select Health Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.76 | Professional | None | $4.68 | $4.68 | $6.76 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
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 $3.39 Median $3.39 Typical High $5.25 | Professional | 52 · Reduced service | $3.39 | $3.39 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.35 Typical High $2.14 | Professional | 53 · Discontinued | $1.35 | $1.35 | $2.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.00 Typical High $2.19 | Professional | 55 · Aftercare only | $1.00 | $1.00 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.68 Typical High $1.45 | Professional | 56 · Pre-op care only | $0.68 | $0.68 | $1.45 |
Where Colorado sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 15th of 51
$8.32
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.