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 $0.06 Median $0.06 Typical High $0.06 | Facility | None | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 52 · Reduced service | $0.03 | $0.03 | $0.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $28.18 Typical High $114.82 | Facility | None | $22.39 | $28.18 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | None | $25.70 | $25.70 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | RR · Rental | $30.20 | $30.20 | $30.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | UE · Used equipment | $22.39 | $22.39 | $22.39 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $630.96 | Professional | None | $10.00 | $12.02 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
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 $0.06 Median $0.09 Typical High $0.09 | Facility | None | $0.06 | $0.09 | $0.09 |
Providence Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
3 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 53 · Discontinued Typical Low $0.20 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.20 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.15 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.10 | $0.40 | $0.40 |
Where California sits
The same service costs 2630.3 times more in Montana than in Nevada. 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· 19th of 51
$0.31
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.