How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $8Professionalmedian $4 · 10th to 90th $2 to $51
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 $1.78 Median $1.95 Typical High $2.04 | Facility | None | $1.78 | $1.95 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $1.95 Typical High $3.02 | Professional | None | $1.78 | $1.95 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.45 Median $3.09 Typical High $12.88 | Facility | None | $2.45 | $3.09 | $12.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $4.79 Typical High $9.55 | Professional | None | $3.47 | $4.79 | $9.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $3.55 | Professional | RR · Rental | $3.31 | $3.31 | $3.55 |
Blue Shield Setting Facility Modifier None Typical Low $7.08 Median $9.33 Typical High $14.13 | Facility | None | $7.08 | $9.33 | $14.13 |
Blue Shield Setting Professional Modifier None Typical Low $7.41 Median $14.13 Typical High $25.12 | Professional | None | $7.41 | $14.13 | $25.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.37 Median $7.76 Typical High $7.94 | Professional | None | $5.37 | $7.76 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.37 Median $7.41 Typical High $8.13 | Professional | None | $5.37 | $7.41 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.07 Median $5.75 Typical High $15.49 | Professional | None | $4.07 | $5.75 | $15.49 |
Lucent Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $51.29 | Professional | None | $33.88 | $33.88 | $51.29 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
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 $1.86 Median $3.98 Typical High $6.76 | Facility | None | $1.86 | $3.98 | $6.76 |
Providence Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.16 Typical High $8.51 | Professional | None | $2.63 | $3.16 | $8.51 |
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 $0.89 Median $0.98 Typical High $1.51 | Professional | 52 · Reduced service | $0.89 | $0.98 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.39 Typical High $0.60 | Professional | 53 · Discontinued | $0.36 | $0.39 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.28 Typical High $0.44 | Professional | 55 · Aftercare only | $0.27 | $0.28 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.20 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.18 | $0.20 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.51 Median $2.51 Typical High $3.55 | Professional | UE · Used equipment | $2.51 | $2.51 | $3.55 |
Where California sits
The same service costs 2.1 times more in Kansas than in Alabama. 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· 36th of 51
$3.98
KS $7.08AL $3.39
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.