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 $0.11 Median $0.26 Typical High $0.55 | Facility | None | $0.11 | $0.26 | $0.55 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | None | $0.12 | $0.12 | $0.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.15 Median $0.22 Typical High $0.39 | Facility | None | $0.15 | $0.22 | $0.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | None | $0.04 | $0.04 | $0.04 |
Cigna Setting Facility Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Facility | None | $0.13 | $0.13 | $0.13 |
Cigna Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
Denver HMP Setting Facility Modifier None Typical Low $0.12 Median $0.15 Typical High $2.63 | Facility | None | $0.12 | $0.15 | $2.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $346.74 | Professional | None | $3.98 | $3.98 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $0.21 Median $0.27 Typical High $0.30 | Professional | None | $0.21 | $0.27 | $0.30 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
3 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 $0.06 Median $0.06 Typical High $0.06 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where Colorado sits
The same service costs 32.4 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· 15th of 51
$0.13
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.