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 $3.47 Median $6.46 Typical High $13.80 | Facility | None | $3.47 | $6.46 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $6.03 | Professional | None | $3.47 | $3.47 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.63 Median $5.75 Typical High $9.77 | Facility | None | $3.63 | $5.75 | $9.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.89 Typical High $4.79 | Facility | None | $3.55 | $3.89 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Denver HMP Setting Facility Modifier None Typical Low $3.47 Median $3.63 Typical High $4.90 | Facility | None | $3.47 | $3.63 | $4.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.57 Median $3.80 Typical High $5.01 | Professional | None | $2.57 | $3.80 | $5.01 |
Select Health Setting Facility Modifier None Typical Low $3.47 Median $6.46 Typical High $7.24 | Facility | None | $3.47 | $6.46 | $7.24 |
Select Health Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $3.47 | Professional | None | $2.40 | $2.40 | $3.47 |
United Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
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 $1.74 Median $1.74 Typical High $3.02 | Professional | 52 · Reduced service | $1.74 | $1.74 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.69 Typical High $1.20 | Professional | 53 · Discontinued | $0.69 | $0.69 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.89 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.60 |
Where Colorado sits
The same service costs 562.3 times more in Alabama than in Oklahoma. 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
$4.17
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.