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 $3.02 Median $6.61 Typical High $13.80 | Facility | None | $3.02 | $6.61 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.16 Typical High $4.57 | Professional | None | $3.02 | $3.16 | $4.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.39 Median $5.25 Typical High $9.12 | Facility | None | $3.39 | $5.25 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.47 Typical High $10.96 | Facility | None | $3.09 | $3.47 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Denver HMP Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $4.37 | Facility | None | $3.02 | $3.02 | $4.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.29 Median $3.31 Typical High $6.03 | Professional | None | $2.29 | $3.31 | $6.03 |
Select Health Setting Facility Modifier None Typical Low $3.02 Median $5.62 Typical High $6.31 | Facility | None | $3.02 | $5.62 | $6.31 |
Select Health Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.02 | Professional | None | $2.14 | $2.14 | $3.02 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
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 $1.51 Median $1.51 Typical High $3.24 | Professional | 52 · Reduced service | $1.51 | $1.51 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $1.32 | Professional | 53 · Discontinued | $0.62 | $0.62 | $1.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.98 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.65 |
Where Colorado sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 14th of 51
$3.80
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.