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 $14.79 Median $14.79 Typical High $26.92 | Facility | None | $14.79 | $14.79 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $17.38 Typical High $21.88 | Facility | None | $15.14 | $17.38 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $4.37 Typical High $14.79 | Professional | None | $3.09 | $4.37 | $14.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.14 Median $15.14 Typical High $18.20 | Professional | RR · Rental | $15.14 | $15.14 | $18.20 |
Blue Shield Setting Professional Modifier None Typical Low $5.13 Median $7.76 Typical High $12.02 | Professional | None | $5.13 | $7.76 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $30.20 Typical High $45.71 | Facility | None | $15.14 | $30.20 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
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 $8.71 Median $21.38 Typical High $40.74 | Facility | None | $8.71 | $21.38 | $40.74 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.19 Typical High $5.01 | Professional | None | $1.78 | $2.19 | $5.01 |
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 $7.41 Median $7.41 Typical High $7.41 | Professional | 52 · Reduced service | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.95 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $1.48 |
Where California sits
The same service costs 4.8 times more in Maryland than in Kentucky. 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· 21st of 51
$14.79
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.