How much rates vary
Facilitymedian $7 · 10th to 90th $4 to $14Professionalmedian $7 · 10th to 90th $4 to $91
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 $3.16 Median $3.47 Typical High $3.63 | Facility | None | $3.16 | $3.47 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $5.37 | Professional | None | $3.16 | $3.47 | $5.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.37 Median $5.62 Typical High $22.91 | Facility | None | $4.37 | $5.62 | $22.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $8.51 Typical High $16.98 | Professional | None | $6.17 | $8.51 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | RR · Rental | $6.03 | $6.03 | $6.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | UE · Used equipment | $4.47 | $4.47 | $4.47 |
Blue Shield Setting Facility Modifier None Typical Low $12.59 Median $16.60 Typical High $25.12 | Facility | None | $12.59 | $16.60 | $25.12 |
Blue Shield Setting Professional Modifier None Typical Low $13.18 Median $25.12 Typical High $44.67 | Professional | None | $13.18 | $25.12 | $44.67 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $9.77 Median $13.80 Typical High $14.13 | Professional | None | $9.77 | $13.80 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.76 | Facility | None | $7.08 | $7.08 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $9.77 Median $13.49 Typical High $14.45 | Professional | None | $9.77 | $13.49 | $14.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.24 Median $10.00 Typical High $28.18 | Professional | None | $7.24 | $10.00 | $28.18 |
Lucent Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $91.20 | Professional | None | $60.26 | $60.26 | $91.20 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
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 $3.39 Median $7.08 Typical High $12.02 | Facility | None | $3.39 | $7.08 | $12.02 |
Providence Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
United Setting Professional Modifier None Typical Low $4.68 Median $5.62 Typical High $15.14 | Professional | None | $4.68 | $5.62 | $15.14 |
4 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 $1.58 Median $1.74 Typical High $2.69 | Professional | 52 · Reduced service | $1.58 | $1.74 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.71 Typical High $1.07 | Professional | 53 · Discontinued | $0.65 | $0.71 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.52 Typical High $0.81 | Professional | 55 · Aftercare only | $0.48 | $0.52 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.35 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.32 | $0.35 | $0.52 |
Where California sits
The same service costs 2.1 times more in Hawaii 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· 33rd of 51
$7.08
HI $12.59DE $6.03
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.