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 $1.41 Median $2.75 Typical High $5.89 | Facility | None | $1.41 | $2.75 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $2.75 | Professional | None | $1.41 | $1.41 | $2.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.51 Median $2.29 Typical High $4.47 | Facility | None | $1.51 | $2.29 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $1.58 Typical High $2.00 | Facility | None | $1.45 | $1.58 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Denver HMP Setting Facility Modifier None Typical Low $1.12 Median $1.41 Typical High $2.00 | Facility | None | $1.12 | $1.41 | $2.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.05 Median $1.55 Typical High $2.82 | Professional | None | $1.05 | $1.55 | $2.82 |
Select Health Setting Facility Modifier None Typical Low $1.41 Median $2.57 Typical High $2.95 | Facility | None | $1.41 | $2.57 | $2.95 |
Select Health Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $1.41 | Professional | None | $0.98 | $0.98 | $1.41 |
United Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
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 $0.71 Median $0.71 Typical High $1.38 | Professional | 52 · Reduced service | $0.71 | $0.71 | $1.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.41 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.27 |
Where Colorado sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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
$1.74
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.