How much rates vary
Facilitymedian $9 · 10th to 90th $5 to $93Professionalmedian $6 · 10th to 90th $4 to $24
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 $5.37 Median $6.46 Typical High $7.08 | Facility | None | $5.37 | $6.46 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $5.37 Typical High $7.08 | Professional | None | $5.01 | $5.37 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.51 Median $2.69 Typical High $3.24 | Professional | 52 · Reduced service | $2.51 | $2.69 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.07 Typical High $1.29 | Professional | 53 · Discontinued | $1.00 | $1.07 | $1.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.79 Typical High $0.95 | Professional | 55 · Aftercare only | $0.76 | $0.79 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.52 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.50 | $0.52 | $0.65 |
Ambetter Setting Professional Modifier None Typical Low $4.57 Median $5.13 Typical High $5.75 | Professional | None | $4.57 | $5.13 | $5.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.51 Median $9.12 Typical High $10.00 | Facility | None | $8.51 | $9.12 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $8.51 Typical High $20.42 | Professional | None | $4.79 | $8.51 | $20.42 |
Blue Shield Setting Facility Modifier None Typical Low $44.67 Median $67.61 Typical High $114.82 | Facility | None | $44.67 | $67.61 | $114.82 |
Blue Shield Setting Professional Modifier None Typical Low $4.27 Median $5.62 Typical High $6.92 | Professional | None | $4.27 | $5.62 | $6.92 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.50 Median $7.59 Typical High $7.59 | Professional | None | $5.50 | $7.59 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $4.07 Typical High $6.61 | Professional | None | $3.98 | $4.07 | $6.61 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.79 Median $6.76 Typical High $7.41 | Professional | None | $4.79 | $6.76 | $7.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.07 Median $5.01 Typical High $6.17 | Professional | None | $4.07 | $5.01 | $6.17 |
Lucent Health Setting Professional Modifier None Typical Low $29.51 Median $44.67 Typical High $44.67 | Professional | None | $29.51 | $44.67 | $44.67 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $60.26 | Professional | None | $6.31 | $6.31 | $60.26 |
Optum Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Providence Setting Facility Modifier None Typical Low $5.37 Median $7.08 Typical High $9.55 | Facility | None | $5.37 | $7.08 | $9.55 |
Providence Setting Professional Modifier None Typical Low $3.98 Median $4.27 Typical High $6.46 | Professional | None | $3.98 | $4.27 | $6.46 |
Sutter Health Plus Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $93.33 | Facility | None | $61.66 | $61.66 | $93.33 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.25 Typical High $12.30 | Professional | None | $3.80 | $5.25 | $12.30 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $4.27 Median $4.57 Typical High $5.01 | Professional | 33 · Preventive service | $4.27 | $4.57 | $5.01 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.37 Median $4.90 Typical High $5.75 | Professional | 59 · Distinct service | $4.37 | $4.90 | $5.75 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 93 · Audio-only telehealth | $5.75 | $5.75 | $5.75 |
HealthNet Setting Professional Modifier XU · Unusual separate service Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | XU · Unusual separate service | $28.18 | $28.18 | $28.18 |
Where California sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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.
California· 17th of 51
$5.75
ND $8.71NM $3.24
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.