How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $3Professionalmedian $2 · 10th to 90th $1 to $20
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 $0.71 Median $0.76 Typical High $0.79 | Facility | None | $0.71 | $0.76 | $0.79 |
Aetna Setting Professional Modifier None Typical Low $0.71 Median $0.76 Typical High $1.12 | Professional | None | $0.71 | $0.76 | $1.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.95 Median $1.23 Typical High $5.01 | Facility | None | $0.95 | $1.23 | $5.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.35 Median $1.82 Typical High $3.80 | Professional | None | $1.35 | $1.82 | $3.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | RR · Rental | $1.29 | $1.29 | $1.29 |
Blue Shield Setting Facility Modifier None Typical Low $2.75 Median $3.63 Typical High $5.50 | Facility | None | $2.75 | $3.63 | $5.50 |
Blue Shield Setting Professional Modifier None Typical Low $2.88 Median $5.50 Typical High $9.77 | Professional | None | $2.88 | $5.50 | $9.77 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.09 Median $3.02 Typical High $3.09 | Professional | None | $2.09 | $3.02 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.70 | Facility | None | $1.55 | $1.55 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.09 Median $2.88 Typical High $3.16 | Professional | None | $2.09 | $2.88 | $3.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.58 Median $2.00 Typical High $6.03 | Professional | None | $1.58 | $2.00 | $6.03 |
Lucent Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $19.95 | Professional | None | $13.18 | $13.18 | $19.95 |
Molina Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
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 $0.72 Median $1.55 Typical High $2.63 | Facility | None | $0.72 | $1.55 | $2.63 |
Providence Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.23 Typical High $3.31 | Professional | None | $1.02 | $1.23 | $3.31 |
5 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 $0.35 Median $0.38 Typical High $0.59 | Professional | 52 · Reduced service | $0.35 | $0.38 | $0.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.15 Typical High $0.23 | Professional | 53 · Discontinued | $0.14 | $0.15 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.18 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.08 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.07 | $0.08 | $0.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.98 Median $0.98 Typical High $1.07 | Professional | UE · Used equipment | $0.98 | $0.98 | $1.07 |
Where California sits
The same service costs 2.3 times more in Kansas 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· 33rd of 51
$1.55
KS $3.09NJ $1.32
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.