How much rates vary
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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $18.20 Typical High $74.13 | Facility | None | $14.45 | $18.20 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $25.70 Typical High $33.88 | Professional | None | $4.27 | $25.70 | $33.88 |
Blue Shield Setting Professional Modifier None Typical Low $30.90 Median $58.88 Typical High $97.72 | Professional | None | $30.90 | $58.88 | $97.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $18.62 | Professional | None | $6.17 | $6.17 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $23.44 Median $25.70 Typical High $31.62 | Professional | None | $23.44 | $25.70 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.13 Median $25.70 Typical High $120.23 | Professional | None | $14.13 | $25.70 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | None | $134.90 | $134.90 | $181.97 |
Providence Setting Facility Modifier None Typical Low $4.27 Median $23.44 Typical High $23.44 | Facility | None | $4.27 | $23.44 | $23.44 |
Providence Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $28.84 | Professional | None | $12.02 | $12.02 | $28.84 |
6 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 $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.43 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.45 Median $1.45 Typical High $12.30 | Professional | RR · Rental | $1.45 | $1.45 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.96 Median $10.96 Typical High $93.33 | Professional | UE · Used equipment | $10.96 | $10.96 | $93.33 |
Where California sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 39th of 51
$13.49
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.