How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $6Professionalmedian $3 · 10th to 90th $2 to $38
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 $1.35 Median $1.48 Typical High $1.55 | Facility | None | $1.35 | $1.48 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $2.19 | Professional | None | $1.35 | $1.48 | $2.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.82 Median $2.34 Typical High $9.77 | Facility | None | $1.82 | $2.34 | $9.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $3.55 Typical High $7.24 | Professional | None | $2.57 | $3.55 | $7.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $2.63 | Professional | RR · Rental | $2.51 | $2.51 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | UE · Used equipment | $1.86 | $1.86 | $1.86 |
Blue Shield Setting Facility Modifier None Typical Low $5.25 Median $7.08 Typical High $10.72 | Facility | None | $5.25 | $7.08 | $10.72 |
Blue Shield Setting Professional Modifier None Typical Low $5.62 Median $10.47 Typical High $18.62 | Professional | None | $5.62 | $10.47 | $18.62 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.07 Median $5.89 Typical High $6.03 | Professional | None | $4.07 | $5.89 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.24 | Facility | None | $3.02 | $3.02 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.07 Median $5.62 Typical High $6.17 | Professional | None | $4.07 | $5.62 | $6.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.09 Median $4.57 Typical High $11.75 | Professional | None | $3.09 | $4.57 | $11.75 |
Lucent Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $38.02 | Professional | None | $25.70 | $25.70 | $38.02 |
Molina Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
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 $1.41 Median $3.02 Typical High $5.13 | Facility | None | $1.41 | $3.02 | $5.13 |
Providence Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
United Setting Professional Modifier None Typical Low $2.00 Median $2.34 Typical High $6.46 | Professional | None | $2.00 | $2.34 | $6.46 |
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 $0.68 Median $0.74 Typical High $1.12 | Professional | 52 · Reduced service | $0.68 | $0.74 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.28 Typical High $0.45 | Professional | 53 · Discontinued | $0.27 | $0.28 | $0.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.22 Typical High $0.33 | Professional | 55 · Aftercare only | $0.20 | $0.22 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.15 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.13 | $0.15 | $0.23 |
Where California sits
The same service costs 2.3 times more in Kansas than in Utah. 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
$3.02
KS $6.03UT $2.57
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.