How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 to $14
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 $0.49 Median $0.52 Typical High $0.56 | Facility | None | $0.49 | $0.52 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.49 Median $0.52 Typical High $0.81 | Professional | None | $0.49 | $0.52 | $0.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.66 Median $0.85 Typical High $3.47 | Facility | None | $0.66 | $0.85 | $3.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.93 Median $1.29 Typical High $2.63 | Professional | None | $0.93 | $1.29 | $2.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | RR · Rental | $0.91 | $0.91 | $0.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | UE · Used equipment | $0.68 | $0.68 | $0.68 |
Blue Shield Setting Facility Modifier None Typical Low $1.91 Median $2.51 Typical High $3.89 | Facility | None | $1.91 | $2.51 | $3.89 |
Blue Shield Setting Professional Modifier None Typical Low $2.04 Median $3.80 Typical High $6.76 | Professional | None | $2.04 | $3.80 | $6.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.10 | Professional | None | $0.93 | $0.93 | $1.10 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.48 Median $2.04 Typical High $2.19 | Professional | None | $1.48 | $2.04 | $2.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.10 Median $1.55 Typical High $4.27 | Professional | None | $1.10 | $1.55 | $4.27 |
Lucent Health Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $13.80 | Professional | None | $9.12 | $9.12 | $13.80 |
Molina Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $33.11 | Professional | None | $1.82 | $1.82 | $33.11 |
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 $0.52 Median $1.10 Typical High $1.82 | Facility | None | $0.52 | $1.10 | $1.82 |
Providence Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.10 | Professional | None | $0.93 | $0.93 | $1.10 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
United Setting Professional Modifier None Typical Low $0.72 Median $0.85 Typical High $2.29 | Professional | None | $0.72 | $0.85 | $2.29 |
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 $0.25 Median $0.27 Typical High $0.40 | Professional | 52 · Reduced service | $0.25 | $0.27 | $0.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.11 Typical High $0.16 | Professional | 53 · Discontinued | $0.10 | $0.11 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.08 Typical High $0.12 | Professional | 55 · Aftercare only | $0.07 | $0.08 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.08 |
Where California sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 32nd of 51
$1.10
HI $1.95NJ $0.93
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.