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 $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.39 | Professional | None | $3.16 | $3.16 | $3.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.17 Median $7.24 Typical High $18.62 | Facility | None | $6.17 | $7.24 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $3.55 Typical High $8.32 | Professional | None | $2.51 | $3.55 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Denver HMP Setting Facility Modifier None Typical Low $1.82 Median $3.63 Typical High $7.59 | Facility | None | $1.82 | $3.63 | $7.59 |
Denver HMP Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $8.51 Typical High $13.49 | Professional | None | $4.90 | $8.51 | $13.49 |
Select Health Setting Facility Modifier None Typical Low $6.46 Median $12.02 Typical High $13.49 | Facility | None | $6.46 | $12.02 | $13.49 |
Select Health Setting Professional Modifier None Typical Low $4.57 Median $6.46 Typical High $9.12 | Professional | None | $4.57 | $6.46 | $9.12 |
United Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
United Setting Professional Modifier None Typical Low $2.51 Median $2.82 Typical High $4.27 | Professional | None | $2.51 | $2.82 | $4.27 |
6 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 $1.58 Median $1.58 Typical High $1.70 | Professional | 52 · Reduced service | $1.58 | $1.58 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.48 Typical High $0.51 | Professional | 55 · Aftercare only | $0.48 | $0.48 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $3.55 Typical High $3.55 | Professional | RR · Rental | $0.34 | $3.55 | $3.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | UE · Used equipment | $2.57 | $2.57 | $2.57 |
Where Colorado sits
The same service costs 4.9 times more in Kansas 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· 47th of 51
$3.16
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.