How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $5Professionalmedian $2 · 10th to 90th $1 to $30
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 $1.05 Median $1.12 Typical High $1.20 | Facility | None | $1.05 | $1.12 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $1.12 Typical High $1.74 | Professional | None | $1.05 | $1.12 | $1.74 |
Ambetter Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.41 Median $1.82 Typical High $7.59 | Facility | None | $1.41 | $1.82 | $7.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $2.75 Typical High $5.50 | Professional | None | $2.00 | $2.75 | $5.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | RR · Rental | $1.95 | $1.95 | $2.04 |
Blue Shield Setting Facility Modifier None Typical Low $4.07 Median $5.50 Typical High $8.13 | Facility | None | $4.07 | $5.50 | $8.13 |
Blue Shield Setting Professional Modifier None Typical Low $4.37 Median $8.13 Typical High $14.79 | Professional | None | $4.37 | $8.13 | $14.79 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.16 Median $4.57 Typical High $4.68 | Professional | None | $3.16 | $4.57 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.16 Median $4.37 Typical High $4.79 | Professional | None | $3.16 | $4.37 | $4.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.40 Median $3.16 Typical High $9.12 | Professional | None | $2.40 | $3.16 | $9.12 |
Lucent Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $29.51 | Professional | None | $19.95 | $19.95 | $29.51 |
Molina Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
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 $1.10 Median $2.34 Typical High $3.98 | Facility | None | $1.10 | $2.34 | $3.98 |
Providence Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.82 Typical High $5.01 | Professional | None | $1.51 | $1.82 | $5.01 |
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 $0.52 Median $0.56 Typical High $0.85 | Professional | 52 · Reduced service | $0.52 | $0.56 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.23 Typical High $0.35 | Professional | 53 · Discontinued | $0.21 | $0.23 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.17 Typical High $0.26 | Professional | 55 · Aftercare only | $0.16 | $0.17 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.45 Median $1.45 Typical High $2.09 | Professional | UE · Used equipment | $1.45 | $1.45 | $2.09 |
Where California sits
The same service costs 2.2 times more in Kansas than in Delaware. 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
$2.34
KS $4.47DE $2.00
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.