How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $6Professionalmedian $3 · 10th to 90th $2 to $40
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 $1.41 Median $1.55 Typical High $1.62 | Facility | None | $1.41 | $1.55 | $1.62 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.55 Typical High $2.34 | Professional | None | $1.41 | $1.55 | $2.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.91 Median $2.45 Typical High $10.23 | Facility | None | $1.91 | $2.45 | $10.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $3.72 Typical High $7.59 | Professional | None | $2.63 | $3.72 | $7.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | RR · Rental | $2.63 | $2.63 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | UE · Used equipment | $1.95 | $1.95 | $1.95 |
Blue Shield Setting Facility Modifier None Typical Low $5.50 Median $7.41 Typical High $11.22 | Facility | None | $5.50 | $7.41 | $11.22 |
Blue Shield Setting Professional Modifier None Typical Low $5.89 Median $10.96 Typical High $19.95 | Professional | None | $5.89 | $10.96 | $19.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.27 Median $6.17 Typical High $6.31 | Professional | None | $4.27 | $6.17 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.27 Median $5.89 Typical High $6.46 | Professional | None | $4.27 | $5.89 | $6.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.24 Median $4.57 Typical High $12.30 | Professional | None | $3.24 | $4.57 | $12.30 |
Lucent Health Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $39.81 | Professional | None | $26.92 | $26.92 | $39.81 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $33.11 | Professional | None | $5.25 | $5.25 | $33.11 |
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 $1.48 Median $3.55 Typical High $5.37 | Facility | None | $1.48 | $3.55 | $5.37 |
Providence Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.45 Typical High $6.76 | Professional | None | $2.09 | $2.45 | $6.76 |
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 $0.71 Median $0.78 Typical High $1.20 | Professional | 52 · Reduced service | $0.71 | $0.78 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.31 Typical High $0.46 | Professional | 53 · Discontinued | $0.28 | $0.31 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.23 Typical High $0.34 | Professional | 55 · Aftercare only | $0.21 | $0.23 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.16 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.14 | $0.16 | $0.24 |
Where California sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 24th of 51
$3.55
KS $6.76NH $2.63
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.