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 $0.50 Median $0.50 Typical High $0.50 | Facility | None | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | None | $0.50 | $0.50 | $0.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.16 Median $0.20 Typical High $0.81 | Facility | None | $0.16 | $0.20 | $0.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.18 Median $0.19 Typical High $1.00 | Professional | None | $0.18 | $0.19 | $1.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | RR · Rental | $0.21 | $0.21 | $0.21 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | UE · Used equipment | $0.16 | $0.16 | $0.16 |
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 $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | None | $0.16 | $0.16 | $0.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $630.96 | Professional | None | $1.00 | $1.00 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Molina Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | None | $0.33 | $0.33 | $0.33 |
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 $0.50 Median $0.72 Typical High $1.07 | Facility | None | $0.50 | $0.72 | $1.07 |
Providence Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
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 $0.25 Median $0.25 Typical High $0.25 | Professional | 52 · Reduced service | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where California sits
The same service costs 3981.1 times more in Oregon than in Hawaii. 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· 12th of 51
$1.20
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.