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 $3.39 Median $8.71 Typical High $131.83 | Facility | None | $3.39 | $8.71 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.47 Typical High $5.25 | Professional | None | $3.39 | $3.47 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $5.75 Typical High $10.00 | Facility | None | $3.80 | $5.75 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $4.79 Typical High $9.77 | Facility | None | $3.98 | $4.79 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Denver HMP Setting Facility Modifier None Typical Low $3.39 Median $3.72 Typical High $4.79 | Facility | None | $3.39 | $3.72 | $4.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.51 Median $3.72 Typical High $6.76 | Professional | None | $2.51 | $3.72 | $6.76 |
Select Health Setting Facility Modifier None Typical Low $3.39 Median $6.17 Typical High $7.08 | Facility | None | $3.39 | $6.17 | $7.08 |
Select Health Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $3.39 | Professional | None | $2.34 | $2.34 | $3.39 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $46.77 | Professional | None | $30.90 | $30.90 | $46.77 |
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 $1.70 Median $1.70 Typical High $22.91 | Professional | 52 · Reduced service | $1.70 | $1.70 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $12.30 | Professional | 53 · Discontinued | $0.68 | $0.68 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $9.33 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $6.17 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $6.17 |
Where Colorado sits
The same service costs 9.1 times more in Rhode Island than in Florida. 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· 39th of 51
$4.47
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.