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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $204.17 | Professional | None | $147.91 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $30.20 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $20.42 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $537.03 | Facility | None | $478.63 | $524.81 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $281.84 | Professional | None | $107.15 | $165.96 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Denver HMP Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $295.12 | Facility | None | $169.82 | $204.17 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $407.38 | Professional | None | $245.47 | $245.47 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $457.09 Typical High $524.81 | Facility | None | $245.47 | $457.09 | $524.81 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $331.13 | Professional | None | $218.78 | $218.78 | $331.13 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $154.88 | Professional | None | $97.72 | $109.65 | $154.88 |
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 |
|---|---|---|---|---|---|
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Colorado sits
The same service costs 2.8 times more in Minnesota than in Utah. 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· 27th of 51
$162
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.