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 $2.19 Median $3.39 Typical High $8.71 | Facility | None | $2.19 | $3.39 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.80 | Professional | None | $2.19 | $2.19 | $3.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.45 Median $3.72 Typical High $6.61 | Facility | None | $2.45 | $3.72 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $2.45 Typical High $3.80 | Facility | None | $2.04 | $2.45 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Denver HMP Setting Facility Modifier None Typical Low $2.19 Median $2.51 Typical High $3.39 | Facility | None | $2.19 | $2.51 | $3.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.62 Median $2.40 Typical High $4.37 | Professional | None | $1.62 | $2.40 | $4.37 |
Select Health Setting Facility Modifier None Typical Low $2.19 Median $4.07 Typical High $4.57 | Facility | None | $2.19 | $4.07 | $4.57 |
Select Health Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.19 | Professional | None | $1.51 | $1.51 | $2.19 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
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 $1.10 Median $1.10 Typical High $2.04 | Professional | 52 · Reduced service | $1.10 | $1.10 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.81 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.62 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.40 |
Where Colorado sits
Rates are fairly even across states for this service. 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· 3rd of 51
$2.69
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.