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 $5.01 Median $10.47 Typical High $22.91 | Facility | None | $5.01 | $10.47 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.80 Typical High $4.90 | Professional | None | $3.63 | $3.80 | $4.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.62 Median $14.79 Typical High $22.91 | Facility | None | $5.62 | $14.79 | $22.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.80 Typical High $4.90 | Professional | None | $3.02 | $3.80 | $4.90 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $6.61 | Professional | None | $2.95 | $2.95 | $6.61 |
Denver HMP Setting Facility Modifier None Typical Low $3.80 Median $4.79 Typical High $7.59 | Facility | None | $3.80 | $4.79 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.98 Median $7.24 Typical High $19.50 | Professional | None | $3.98 | $7.24 | $19.50 |
Select Health Setting Facility Modifier None Typical Low $4.90 Median $9.12 Typical High $10.47 | Facility | None | $4.90 | $9.12 | $10.47 |
Select Health Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.90 | Professional | None | $3.47 | $3.47 | $4.90 |
United Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.57 Typical High $3.63 | Professional | None | $2.09 | $2.57 | $3.63 |
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 $1.82 Median $1.86 Typical High $2.45 | Professional | 52 · Reduced service | $1.82 | $1.86 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.76 Typical High $1.00 | Professional | 53 · Discontinued | $0.72 | $0.76 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.74 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.38 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.37 | $0.38 | $0.50 |
Where Colorado sits
The same service costs 3.6 times more in Mississippi than in Kentucky. 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· 20th of 51
$4.90
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.