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 $5.25 Median $8.32 Typical High $20.89 | Facility | None | $5.25 | $8.32 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.03 | Professional | None | $5.25 | $5.25 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.75 Median $8.71 Typical High $16.98 | Facility | None | $5.75 | $8.71 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $7.41 Typical High $10.72 | Facility | None | $6.17 | $7.41 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Denver HMP Setting Facility Modifier None Typical Low $4.79 Median $5.89 Typical High $7.59 | Facility | None | $4.79 | $5.89 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $7.59 | Professional | None | $5.25 | $5.75 | $7.59 |
Select Health Setting Facility Modifier None Typical Low $5.25 Median $9.77 Typical High $10.96 | Facility | None | $5.25 | $9.77 | $10.96 |
Select Health Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.59 | Professional | None | $5.25 | $5.25 | $7.59 |
United Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | None | $4.90 | $4.90 | $5.25 |
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 $2.63 Median $2.63 Typical High $2.75 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.12 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.83 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.55 |
Where Colorado sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 51st of 51
$5.25
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.