How much rates vary
Facilitymedian $6 · 10th to 90th $3 to $10Professionalmedian $5 · 10th to 90th $3 to $74
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 $2.57 Median $2.82 Typical High $2.95 | Facility | None | $2.57 | $2.82 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $4.17 | Professional | None | $2.57 | $2.82 | $4.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.02 Median $3.89 Typical High $15.85 | Facility | None | $3.02 | $3.89 | $15.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.07 Median $6.46 Typical High $12.59 | Professional | None | $4.07 | $6.46 | $12.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | RR · Rental | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | UE · Used equipment | $3.09 | $3.09 | $3.09 |
Blue Shield Setting Facility Modifier None Typical Low $8.91 Median $12.02 Typical High $18.20 | Facility | None | $8.91 | $12.02 | $18.20 |
Blue Shield Setting Professional Modifier None Typical Low $9.55 Median $18.20 Typical High $32.36 | Professional | None | $9.55 | $18.20 | $32.36 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $6.17 | Facility | None | $5.75 | $5.75 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | None | $4.90 | $4.90 | $5.75 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.92 Median $9.55 Typical High $10.47 | Professional | None | $6.92 | $9.55 | $10.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.50 Median $7.76 Typical High $19.95 | Professional | None | $5.50 | $7.76 | $19.95 |
Lucent Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $74.13 | Professional | None | $63.10 | $63.10 | $74.13 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $33.11 | Professional | None | $9.77 | $9.77 | $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 $2.75 Median $5.75 Typical High $8.71 | Facility | None | $2.75 | $5.75 | $8.71 |
Providence Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | None | $4.90 | $4.90 | $5.75 |
Sutter Health Plus Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $3.89 Median $4.37 Typical High $10.96 | Professional | None | $3.89 | $4.37 | $10.96 |
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 $1.29 Median $1.41 Typical High $2.09 | Professional | 52 · Reduced service | $1.29 | $1.41 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.56 Typical High $0.83 | Professional | 53 · Discontinued | $0.52 | $0.56 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.43 Typical High $0.63 | Professional | 55 · Aftercare only | $0.39 | $0.43 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.28 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.26 | $0.28 | $0.42 |
Where California sits
The same service costs 2.5 times more in Montana 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· 33rd of 51
$5.62
MT $10.23NH $4.07
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.