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 $2.29 Median $2.88 Typical High $5.75 | Facility | None | $2.29 | $2.88 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.40 Typical High $3.47 | Professional | None | $2.29 | $2.40 | $3.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.57 Median $3.89 Typical High $6.92 | Facility | None | $2.57 | $3.89 | $6.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $2.57 Typical High $2.95 | Facility | None | $1.58 | $2.57 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Denver HMP Setting Facility Modifier None Typical Low $1.00 Median $2.29 Typical High $3.31 | Facility | None | $1.00 | $2.29 | $3.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.74 Median $2.51 Typical High $4.57 | Professional | None | $1.74 | $2.51 | $4.57 |
Select Health Setting Facility Modifier None Typical Low $2.29 Median $4.27 Typical High $4.79 | Facility | None | $2.29 | $4.27 | $4.79 |
Select Health Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $2.29 | Professional | None | $1.62 | $1.62 | $2.29 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.86 | Professional | None | $1.66 | $1.66 | $1.86 |
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 $1.15 Median $1.15 Typical High $1.66 | Professional | 52 · Reduced service | $1.15 | $1.15 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.46 Typical High $0.66 | Professional | 53 · Discontinued | $0.46 | $0.46 | $0.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.35 Typical High $0.50 | Professional | 55 · Aftercare only | $0.35 | $0.35 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.33 |
Where Colorado sits
The same service costs 3.8 times more in Alaska 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· 6th of 51
$2.57
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.