How much rates vary
Facilitymedian $8 · 10th to 90th $5 to $15Professionalmedian $8 · 10th to 90th $4 to $102
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 $3.72 Median $4.07 Typical High $4.07 | Facility | None | $3.72 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $4.07 Typical High $6.76 | Professional | None | $3.72 | $4.07 | $6.76 |
Ambetter Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.79 Median $6.17 Typical High $25.70 | Facility | None | $4.79 | $6.17 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $9.55 Typical High $19.50 | Professional | None | $6.61 | $9.55 | $19.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | RR · Rental | $6.61 | $6.61 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | UE · Used equipment | $4.90 | $4.90 | $4.90 |
Blue Shield Setting Facility Modifier None Typical Low $14.13 Median $18.62 Typical High $28.18 | Facility | None | $14.13 | $18.62 | $28.18 |
Blue Shield Setting Professional Modifier None Typical Low $15.14 Median $28.18 Typical High $50.12 | Professional | None | $15.14 | $28.18 | $50.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $10.96 Median $15.85 Typical High $15.85 | Professional | None | $10.96 | $15.85 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.13 | Professional | None | $6.92 | $6.92 | $8.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.96 Median $15.14 Typical High $16.60 | Professional | None | $10.96 | $15.14 | $16.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.13 Median $10.96 Typical High $31.62 | Professional | None | $8.13 | $10.96 | $31.62 |
Lucent Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $102.33 | Professional | None | $67.61 | $67.61 | $102.33 |
Molina Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $33.11 | Professional | None | $13.49 | $13.49 | $33.11 |
Providence Setting Facility Modifier None Typical Low $6.03 Median $8.13 Typical High $13.80 | Facility | None | $6.03 | $8.13 | $13.80 |
Providence Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.13 | Professional | None | $6.92 | $6.92 | $8.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
United Setting Professional Modifier None Typical Low $5.37 Median $6.31 Typical High $16.98 | Professional | None | $5.37 | $6.31 | $16.98 |
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 $1.82 Median $2.04 Typical High $3.09 | Professional | 52 · Reduced service | $1.82 | $2.04 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.81 Typical High $1.23 | Professional | 53 · Discontinued | $0.74 | $0.81 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.60 Typical High $0.93 | Professional | 55 · Aftercare only | $0.55 | $0.60 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.40 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.37 | $0.40 | $0.62 |
Where California sits
The same service costs 2.2 times more in Hawaii than in Maine. 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· 34th of 51
$8.13
HI $15.49ME $6.92
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.