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 $3.55 Median $5.50 Typical High $14.45 | Facility | None | $3.55 | $5.50 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.01 | Professional | None | $3.55 | $3.55 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.98 Median $6.03 Typical High $10.72 | Facility | None | $3.98 | $6.03 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $4.07 Typical High $7.76 | Facility | None | $3.63 | $4.07 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Denver HMP Setting Facility Modifier None Typical Low $3.39 Median $3.98 Typical High $5.13 | Facility | None | $3.39 | $3.98 | $5.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.69 Median $3.89 Typical High $5.89 | Professional | None | $2.69 | $3.89 | $5.89 |
Select Health Setting Facility Modifier None Typical Low $3.55 Median $6.61 Typical High $7.41 | Facility | None | $3.55 | $6.61 | $7.41 |
Select Health Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.55 | Professional | None | $2.51 | $2.51 | $3.55 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
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 $1.78 Median $1.78 Typical High $3.39 | Professional | 52 · Reduced service | $1.78 | $1.78 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $1.35 | Professional | 53 · Discontinued | $0.71 | $0.71 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $1.02 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.68 |
Where Colorado sits
The same service costs 4.0 times more in Oklahoma than in Maryland. 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· 8th of 51
$4.37
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.