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 $1.10 Median $1.20 Typical High $1.26 | Facility | None | $1.10 | $1.20 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.20 Typical High $1.95 | Professional | None | $1.10 | $1.20 | $1.95 |
Ambetter Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.95 Median $2.45 Typical High $10.00 | Facility | None | $1.95 | $2.45 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $3.80 Typical High $5.01 | Professional | None | $1.74 | $3.80 | $5.01 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.47 Median $3.80 Typical High $4.68 | Professional | None | $3.47 | $3.80 | $4.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $120.23 | Professional | None | $3.02 | $3.98 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $26.30 | Professional | None | $17.38 | $17.38 | $26.30 |
Molina Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Providence Setting Facility Modifier None Typical Low $1.20 Median $2.57 Typical High $3.47 | Facility | None | $1.20 | $2.57 | $3.47 |
Providence Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.70 Typical High $4.47 | Professional | None | $1.55 | $1.70 | $4.47 |
6 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 $0.55 Median $0.60 Typical High $0.98 | Professional | 52 · Reduced service | $0.55 | $0.60 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.24 Typical High $0.39 | Professional | 53 · Discontinued | $0.22 | $0.24 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.18 Typical High $0.28 | Professional | 55 · Aftercare only | $0.16 | $0.18 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.12 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.11 | $0.12 | $0.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.17 Median $0.17 Typical High $1.58 | Professional | RR · Rental | $0.17 | $0.17 | $1.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.29 Median $1.29 Typical High $3.47 | Professional | UE · Used equipment | $1.29 | $1.29 | $3.47 |
Where California sits
The same service costs 2.3 times more in Hawaii than in Kentucky. 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· 22nd of 51
$2.45
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.