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 $0.44 Median $0.87 Typical High $1.86 | Facility | None | $0.44 | $0.87 | $1.86 |
Aetna Setting Professional Modifier None Typical Low $0.44 Median $0.46 Typical High $0.66 | Professional | None | $0.44 | $0.46 | $0.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.49 Median $0.76 Typical High $1.32 | Facility | None | $0.49 | $0.76 | $1.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | None | $0.44 | $0.44 | $0.44 |
Cigna Setting Facility Modifier None Typical Low $0.39 Median $0.50 Typical High $0.59 | Facility | None | $0.39 | $0.50 | $0.59 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.54 | Professional | None | $0.44 | $0.44 | $0.54 |
Denver HMP Setting Facility Modifier None Typical Low $0.39 Median $0.48 Typical High $0.63 | Facility | None | $0.39 | $0.48 | $0.63 |
Denver HMP Setting Professional Modifier None Typical Low $0.45 Median $0.47 Typical High $0.50 | Professional | None | $0.45 | $0.47 | $0.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.42 Median $0.49 Typical High $0.72 | Professional | None | $0.42 | $0.49 | $0.72 |
Select Health Setting Facility Modifier None Typical Low $0.44 Median $0.81 Typical High $0.91 | Facility | None | $0.44 | $0.81 | $0.91 |
Select Health Setting Professional Modifier None Typical Low $0.31 Median $0.44 Typical High $3.02 | Professional | None | $0.31 | $0.44 | $3.02 |
United Setting Professional Modifier None Typical Low $0.33 Median $0.44 Typical High $0.44 | Professional | None | $0.33 | $0.44 | $0.44 |
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 $0.22 Median $0.22 Typical High $0.24 | Professional | 52 · Reduced service | $0.22 | $0.22 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.12 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Where Colorado sits
The same service costs 1.6 times more in Alaska than in Montana. 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· 8th of 51
$0.47
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.