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 $0.05 Median $0.05 Typical High $0.05 | Facility | None | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.08 | Professional | None | $0.05 | $0.05 | $0.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.06 Median $0.07 Typical High $0.31 | Facility | None | $0.06 | $0.07 | $0.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.08 Median $0.10 Typical High $0.11 | Professional | None | $0.08 | $0.10 | $0.11 |
Blue Shield Setting Facility Modifier None Typical Low $0.18 Median $0.24 Typical High $0.36 | Facility | None | $0.18 | $0.24 | $0.36 |
Blue Shield Setting Professional Modifier None Typical Low $0.18 Median $0.33 Typical High $0.58 | Professional | None | $0.18 | $0.33 | $0.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.12 Median $0.27 Typical High $0.28 | Professional | None | $0.12 | $0.27 | $0.28 |
Cigna Setting Facility Modifier None Typical Low $0.09 Median $0.09 Typical High $0.10 | Facility | None | $0.09 | $0.09 | $0.10 |
Cigna Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | None | $0.08 | $0.08 | $0.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.12 Median $0.17 Typical High $0.18 | Professional | None | $0.12 | $0.17 | $0.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.09 Median $0.14 Typical High $0.38 | Professional | None | $0.09 | $0.14 | $0.38 |
Lucent Health Setting Professional Modifier None Typical Low $1.12 Median $3.72 Typical High $3.72 | Professional | None | $1.12 | $3.72 | $3.72 |
Molina Setting Professional Modifier None Typical Low $0.16 Median $0.16 Typical High $33.11 | Professional | None | $0.16 | $0.16 | $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 $0.05 Median $0.09 Typical High $0.15 | Facility | None | $0.05 | $0.09 | $0.15 |
Providence Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | None | $0.08 | $0.08 | $0.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
United Setting Professional Modifier None Typical Low $0.07 Median $0.08 Typical High $0.19 | Professional | None | $0.07 | $0.08 | $0.19 |
3 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 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | RR · Rental | $0.08 | $0.08 | $0.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.06 Median $0.06 Typical High $0.08 | Professional | UE · Used equipment | $0.06 | $0.06 | $0.08 |
Where California sits
The same service costs 2.0 times more in Idaho than in Ohio. 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· 34th of 51
$0.09
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.