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 $1.32 Median $2.63 Typical High $5.62 | Facility | None | $1.32 | $2.63 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $2.63 | Professional | None | $1.32 | $1.32 | $2.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.45 Median $2.09 Typical High $4.27 | Facility | None | $1.45 | $2.09 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Cigna Setting Facility Modifier None Typical Low $1.35 Median $1.51 Typical High $1.86 | Facility | None | $1.35 | $1.51 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Denver HMP Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.91 | Facility | None | $1.32 | $1.32 | $1.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.45 Typical High $2.63 | Professional | None | $1.00 | $1.45 | $2.63 |
Select Health Setting Facility Modifier None Typical Low $1.32 Median $2.45 Typical High $2.82 | Facility | None | $1.32 | $2.45 | $2.82 |
Select Health Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.32 | Professional | None | $0.93 | $0.93 | $1.32 |
United Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
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 $0.68 Median $0.68 Typical High $1.32 | Professional | 52 · Reduced service | $0.68 | $0.68 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.52 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.40 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.26 |
Where Colorado sits
The same service costs 1.5 times more in Alaska than in Virginia. 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
$1.66
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.