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 $0.39 Median $0.39 Typical High $0.39 | Facility | None | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.40 | Professional | None | $0.39 | $0.39 | $0.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.76 Median $0.83 Typical High $2.29 | Facility | None | $0.76 | $0.83 | $2.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.35 Median $0.59 Typical High $0.98 | Professional | None | $0.35 | $0.59 | $0.98 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Facility | None | $0.42 | $0.42 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.45 | Professional | None | $0.36 | $0.36 | $0.45 |
Denver HMP Setting Facility Modifier None Typical Low $0.22 Median $0.44 Typical High $0.91 | Facility | None | $0.22 | $0.44 | $0.91 |
Denver HMP Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.59 Median $1.02 Typical High $1.66 | Professional | None | $0.59 | $1.02 | $1.66 |
Select Health Setting Facility Modifier None Typical Low $0.79 Median $1.45 Typical High $1.66 | Facility | None | $0.79 | $1.45 | $1.66 |
Select Health Setting Professional Modifier None Typical Low $0.55 Median $0.79 Typical High $1.12 | Professional | None | $0.55 | $0.79 | $1.12 |
United Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
United Setting Professional Modifier None Typical Low $0.30 Median $0.34 Typical High $0.51 | Professional | None | $0.30 | $0.34 | $0.51 |
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 $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.06 Median $0.59 Typical High $0.59 | Professional | RR · Rental | $0.06 | $0.59 | $0.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | UE · Used equipment | $0.44 | $0.44 | $0.44 |
Where Colorado sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 45th of 51
$0.39
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.