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 $1.26 Median $1.38 Typical High $1.45 | Facility | None | $1.26 | $1.38 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.38 Typical High $2.69 | Professional | None | $1.26 | $1.38 | $2.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.58 Median $2.00 Typical High $8.32 | Facility | None | $1.58 | $2.00 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $5.37 Typical High $7.08 | Professional | None | $1.82 | $5.37 | $7.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | RR · Rental | $2.14 | $2.14 | $2.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | UE · Used equipment | $1.62 | $1.62 | $1.62 |
Blue Shield Setting Facility Modifier None Typical Low $5.01 Median $6.61 Typical High $10.00 | Facility | None | $5.01 | $6.61 | $10.00 |
Blue Shield Setting Professional Modifier None Typical Low $5.50 Median $8.91 Typical High $17.78 | Professional | None | $5.50 | $8.91 | $17.78 |
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 $4.90 Median $5.37 Typical High $6.61 | Professional | None | $4.90 | $5.37 | $6.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.98 Median $5.62 Typical High $120.23 | Professional | None | $3.98 | $5.62 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $36.31 | Professional | None | $23.99 | $23.99 | $36.31 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
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 $1.45 Median $4.37 Typical High $4.90 | Facility | None | $1.45 | $4.37 | $4.90 |
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 $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.14 Typical High $6.03 | Professional | None | $1.91 | $2.14 | $6.03 |
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 $0.65 Median $0.71 Typical High $1.35 | Professional | 52 · Reduced service | $0.65 | $0.71 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.28 Typical High $0.54 | Professional | 53 · Discontinued | $0.25 | $0.28 | $0.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.21 Typical High $0.40 | Professional | 55 · Aftercare only | $0.19 | $0.21 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.14 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.13 | $0.14 | $0.27 |
Where California sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 47th of 51
$2.04
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.