How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $4
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 $0.17 Median $0.18 Typical High $0.25 | Facility | None | $0.17 | $0.18 | $0.25 |
Aetna Setting Professional Modifier None Typical Low $0.17 Median $0.18 Typical High $0.21 | Professional | None | $0.17 | $0.18 | $0.21 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.17 Median $0.17 Typical High $0.19 | Professional | RR · Rental | $0.17 | $0.17 | $0.19 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.19 Median $0.24 Typical High $0.98 | Facility | None | $0.19 | $0.24 | $0.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.22 Median $0.59 Typical High $1.26 | Professional | None | $0.22 | $0.59 | $1.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.25 Median $0.25 Typical High $1.05 | Professional | RR · Rental | $0.25 | $0.25 | $1.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | UE · Used equipment | $0.19 | $0.19 | $0.19 |
Blue Shield Setting Facility Modifier None Typical Low $0.66 Median $0.87 Typical High $1.32 | Facility | None | $0.66 | $0.87 | $1.32 |
Blue Shield Setting Professional Modifier None Typical Low $0.71 Median $1.12 Typical High $2.34 | Professional | None | $0.71 | $1.12 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.63 Median $0.69 Typical High $0.85 | Professional | None | $0.63 | $0.69 | $0.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.56 Median $0.81 Typical High $120.23 | Professional | None | $0.56 | $0.81 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Molina Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | None | $0.91 | $0.91 | $0.91 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $0.19 Median $0.59 Typical High $0.63 | Facility | None | $0.19 | $0.59 | $0.63 |
Providence Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | None | $1.15 | $1.15 | $1.15 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.28 Typical High $0.79 | Professional | None | $0.25 | $0.28 | $0.79 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.09 Median $0.09 Typical High $0.15 | Professional | 52 · Reduced service | $0.09 | $0.09 | $0.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.04 Typical High $0.06 | Professional | 53 · Discontinued | $0.03 | $0.04 | $0.06 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.03 |
Where California sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 49th of 51
$0.26
HI $1.05RI $0.23
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.