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 $0.35 Median $0.54 Typical High $1.48 | Facility | None | $0.35 | $0.54 | $1.48 |
Aetna Setting Professional Modifier None Typical Low $0.35 Median $0.37 Typical High $0.52 | Professional | None | $0.35 | $0.37 | $0.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.37 Median $0.58 Typical High $1.00 | Facility | None | $0.37 | $0.58 | $1.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Cigna Setting Facility Modifier None Typical Low $0.26 Median $0.42 Typical High $0.42 | Facility | None | $0.26 | $0.42 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Denver HMP Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $0.50 | Facility | None | $0.35 | $0.35 | $0.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.26 Median $0.39 Typical High $0.71 | Professional | None | $0.26 | $0.39 | $0.71 |
Select Health Setting Facility Modifier None Typical Low $0.35 Median $0.65 Typical High $0.74 | Facility | None | $0.35 | $0.65 | $0.74 |
Select Health Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.35 | Professional | None | $0.25 | $0.25 | $0.35 |
United Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Facility | None | $0.35 | $0.35 | $0.35 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.39 | Professional | None | $0.35 | $0.35 | $0.39 |
2 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 $0.18 Median $0.18 Typical High $0.35 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.11 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.11 |
Where Colorado sits
The same service costs 3.0 times more in Texas than in North Dakota. 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· 14th of 51
$0.42
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.