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 $1.26 Median $2.75 Typical High $5.89 | Facility | None | $1.26 | $2.75 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $2.75 | Professional | None | $1.26 | $1.26 | $2.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.35 Median $2.04 Typical High $3.98 | Facility | None | $1.35 | $2.04 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Cigna Setting Facility Modifier None Typical Low $1.26 Median $1.41 Typical High $1.78 | Facility | None | $1.26 | $1.41 | $1.78 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Denver HMP Setting Facility Modifier None Typical Low $1.12 Median $1.32 Typical High $1.78 | Facility | None | $1.12 | $1.32 | $1.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.93 Median $1.38 Typical High $2.45 | Professional | None | $0.93 | $1.38 | $2.45 |
Select Health Setting Facility Modifier None Typical Low $1.26 Median $2.29 Typical High $2.63 | Facility | None | $1.26 | $2.29 | $2.63 |
Select Health Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $1.26 | Professional | None | $0.87 | $0.87 | $1.26 |
United Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
3 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 $0.63 Median $0.63 Typical High $1.38 | Professional | 52 · Reduced service | $0.63 | $0.63 | $1.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.56 | Professional | 53 · Discontinued | $0.25 | $0.25 | $0.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.42 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.42 |
Where Colorado sits
The same service costs 1.7 times more in Arizona 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· 3rd of 51
$1.55
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.