How much rates vary
Facilitymedian $54 · 10th to 90th $10 to $126Professionalmedian $9 · 10th to 90th $6 to $76
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 $7.41 Median $14.45 Typical High $51.29 | Facility | None | $7.41 | $14.45 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $9.33 Typical High $15.85 | Professional | None | $7.08 | $9.33 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $389.05 | Facility | None | $74.13 | $95.50 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $75.86 Typical High $79.43 | Professional | None | $10.00 | $75.86 | $79.43 |
Blue Shield Setting Facility Modifier None Typical Low $18.20 Median $51.29 Typical High $83.18 | Facility | None | $18.20 | $51.29 | $83.18 |
Blue Shield Setting Professional Modifier None Typical Low $4.68 Median $6.76 Typical High $8.51 | Professional | None | $4.68 | $6.76 | $8.51 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $6.92 Median $8.51 Typical High $21.38 | Professional | None | $6.92 | $8.51 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $316.23 Typical High $316.23 | Facility | None | $4.07 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $8.13 Typical High $13.80 | Professional | None | $6.03 | $8.13 | $13.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.59 Median $9.77 Typical High $12.59 | Professional | None | $7.59 | $9.77 | $12.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $6.61 Typical High $14.79 | Professional | None | $5.01 | $6.61 | $14.79 |
Lucent Health Setting Professional Modifier None Typical Low $10.47 Median $56.23 Typical High $57.54 | Professional | None | $10.47 | $56.23 | $57.54 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $10.72 Typical High $70.79 | Professional | None | $7.94 | $10.72 | $70.79 |
Optum Setting Professional Modifier None Typical Low $3.98 Median $54.95 Typical High $70.79 | Professional | None | $3.98 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $7.24 Median $10.47 Typical High $23.44 | Facility | None | $7.24 | $10.47 | $23.44 |
Providence Setting Professional Modifier None Typical Low $6.03 Median $8.13 Typical High $13.49 | Professional | None | $6.03 | $8.13 | $13.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $19.50 | Professional | None | $3.98 | $3.98 | $19.50 |
United Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
United Setting Professional Modifier None Typical Low $5.50 Median $6.17 Typical High $11.22 | Professional | None | $5.50 | $6.17 | $11.22 |
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 59 · Distinct service Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 59 · Distinct service | $5.13 | $5.13 | $5.13 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | GO · Occupational therapy plan | $5.37 | $5.37 | $5.62 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | GP · Physical therapy plan | $5.13 | $5.13 | $5.13 |
HealthNet Setting Professional Modifier GO · Occupational therapy plan Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | GO · Occupational therapy plan | $97.72 | $97.72 | $97.72 |
Where California sits
The same service costs 2.6 times more in North Dakota than in Missouri. 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· 6th of 51
$9.12
ND $12.02MO $4.68
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.