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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | None | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $29.51 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.79 | $18.20 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $457.09 Typical High $467.74 | Facility | None | $416.87 | $457.09 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $275.42 | Professional | None | $93.33 | $162.18 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $186.21 Typical High $257.04 | Facility | None | $151.36 | $186.21 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $354.81 | Professional | None | $218.78 | $218.78 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $398.11 Typical High $457.09 | Facility | None | $218.78 | $398.11 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $295.12 | Professional | None | $190.55 | $190.55 | $295.12 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $151.36 | Professional | None | $95.50 | $104.71 | $151.36 |
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 3.3 times more in Alaska than in Indiana. 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· 32nd of 51
$158
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.