How much rates vary
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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $22.91 | Professional | None | $19.95 | $19.95 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $3.72 Typical High $15.49 | Facility | None | $2.95 | $3.72 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.98 Typical High $39.81 | Professional | None | $3.39 | $3.98 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | RR · Rental | $3.98 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | UE · Used equipment | $3.02 | $3.02 | $3.02 |
Blue Shield Setting Professional Modifier None Typical Low $2.69 Median $3.72 Typical High $5.50 | Professional | None | $2.69 | $3.72 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | None | $0.91 | $0.91 | $0.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $630.96 | Professional | None | $48.98 | $60.26 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
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 Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | None | $0.91 | $0.91 | $0.91 |
United Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
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 $10.00 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.00 |
Where California sits
The same service costs 87.1 times more in Montana than in West Virginia. 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· 38th of 51
$4.79
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.