How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $11Professionalmedian $5 · 10th to 90th $3 to $69
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 $2.45 Median $2.69 Typical High $2.82 | Facility | None | $2.45 | $2.69 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $2.69 Typical High $4.07 | Professional | None | $2.45 | $2.69 | $4.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.31 Median $4.27 Typical High $17.78 | Facility | None | $3.31 | $4.27 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.68 Median $6.46 Typical High $12.88 | Professional | None | $4.68 | $6.46 | $12.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $4.79 | Professional | RR · Rental | $4.57 | $4.57 | $4.79 |
Blue Shield Setting Facility Modifier None Typical Low $9.55 Median $12.59 Typical High $19.05 | Facility | None | $9.55 | $12.59 | $19.05 |
Blue Shield Setting Professional Modifier None Typical Low $10.23 Median $19.05 Typical High $33.88 | Professional | None | $10.23 | $19.05 | $33.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $7.41 Median $10.72 Typical High $10.96 | Professional | None | $7.41 | $10.72 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.89 | Facility | None | $5.50 | $5.50 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.41 Median $10.23 Typical High $11.22 | Professional | None | $7.41 | $10.23 | $11.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.62 Median $7.94 Typical High $21.38 | Professional | None | $5.62 | $7.94 | $21.38 |
Lucent Health Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Professional | None | $46.77 | $46.77 | $69.18 |
Molina Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
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 $2.57 Median $5.50 Typical High $9.33 | Facility | None | $2.57 | $5.50 | $9.33 |
Providence Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Sutter Health Plus Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $3.63 Median $4.27 Typical High $11.48 | Professional | None | $3.63 | $4.27 | $11.48 |
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 $1.23 Median $1.35 Typical High $2.04 | Professional | 52 · Reduced service | $1.23 | $1.35 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.49 Median $0.52 Typical High $0.81 | Professional | 53 · Discontinued | $0.49 | $0.52 | $0.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.40 Typical High $0.62 | Professional | 55 · Aftercare only | $0.37 | $0.40 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.27 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.24 | $0.27 | $0.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.39 Median $3.39 Typical High $4.90 | Professional | UE · Used equipment | $3.39 | $3.39 | $4.90 |
Where California sits
The same service costs 2.3 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· 34th of 51
$5.50
KS $10.72AL $4.68
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.