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 $1.58 Median $3.16 Typical High $6.76 | Facility | None | $1.58 | $3.16 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $3.16 | Professional | None | $1.58 | $1.58 | $3.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.70 Median $2.57 Typical High $5.01 | Facility | None | $1.70 | $2.57 | $5.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Cigna Setting Facility Modifier None Typical Low $1.62 Median $1.78 Typical High $2.24 | Facility | None | $1.62 | $1.78 | $2.24 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Denver HMP Setting Facility Modifier None Typical Low $1.41 Median $1.66 Typical High $2.24 | Facility | None | $1.41 | $1.66 | $2.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.20 Median $1.74 Typical High $2.24 | Professional | None | $1.20 | $1.74 | $2.24 |
Select Health Setting Facility Modifier None Typical Low $1.58 Median $2.95 Typical High $3.31 | Facility | None | $1.58 | $2.95 | $3.31 |
Select Health Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.58 | Professional | None | $1.12 | $1.12 | $1.58 |
United Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
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 $0.79 Median $0.79 Typical High $1.58 | Professional | 52 · Reduced service | $0.79 | $0.79 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.63 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.47 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.31 |
Where Colorado sits
The same service costs 1.7 times more in Arizona than in Alabama. 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· 7th of 51
$1.95
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.