How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.78 Median $0.78 Typical High $0.78 | Facility | None | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier None Typical Low $0.72 Median $0.78 Typical High $0.95 | Professional | None | $0.72 | $0.78 | $0.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.12 Median $1.51 Typical High $2.51 | Professional | None | $1.12 | $1.51 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $0.47 Median $0.85 Typical High $0.85 | Professional | None | $0.47 | $0.85 | $0.85 |
Denver HMP Setting Facility Modifier None Typical Low $0.78 Median $1.05 Typical High $1.51 | Facility | None | $0.78 | $1.05 | $1.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Select Health Setting Facility Modifier None Typical Low $1.26 Median $2.29 Typical High $2.63 | Facility | None | $1.26 | $2.29 | $2.63 |
Select Health Setting Professional Modifier None Typical Low $0.87 Median $1.12 Typical High $1.26 | Professional | None | $0.87 | $1.12 | $1.26 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.48 Typical High $2.40 | Professional | None | $1.02 | $1.48 | $2.40 |
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 $0.36 Median $0.39 Typical High $0.48 | Professional | 52 · Reduced service | $0.36 | $0.39 | $0.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.16 Typical High $0.18 | Professional | 53 · Discontinued | $0.14 | $0.16 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.12 Typical High $0.14 | Professional | 55 · Aftercare only | $0.11 | $0.12 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.08 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.07 | $0.08 | $0.09 |
Where Colorado sits
The same service costs 104.7 times more in Wyoming than in Connecticut. 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· 12th of 51
$1.41
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.