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 $2.14 Median $4.27 Typical High $9.12 | Facility | None | $2.14 | $4.27 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $4.27 | Professional | None | $2.14 | $2.14 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.29 Median $3.47 Typical High $6.76 | Facility | None | $2.29 | $3.47 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Cigna Setting Facility Modifier None Typical Low $2.14 Median $2.40 Typical High $3.02 | Facility | None | $2.14 | $2.40 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Denver HMP Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $3.02 | Facility | None | $2.14 | $2.14 | $3.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.58 Median $2.34 Typical High $4.27 | Professional | None | $1.58 | $2.34 | $4.27 |
Select Health Setting Facility Modifier None Typical Low $2.14 Median $3.89 Typical High $4.47 | Facility | None | $2.14 | $3.89 | $4.47 |
Select Health Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $2.14 | Professional | None | $1.48 | $1.48 | $2.14 |
United Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
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 $1.07 Median $1.07 Typical High $2.14 | Professional | 52 · Reduced service | $1.07 | $1.07 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $0.85 | Professional | 53 · Discontinued | $0.42 | $0.42 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.65 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.43 |
Where Colorado sits
The same service costs 1.9 times more in Alaska than in Delaware. 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
$2.63
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.