How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $2
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 $0.12 Median $0.13 Typical High $0.14 | Facility | None | $0.12 | $0.13 | $0.14 |
Aetna Setting Professional Modifier None Typical Low $0.13 Median $0.14 Typical High $0.25 | Professional | None | $0.13 | $0.14 | $0.25 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.15 Median $0.19 Typical High $0.78 | Facility | None | $0.15 | $0.19 | $0.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.49 Typical High $0.65 | Professional | None | $0.20 | $0.49 | $0.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | UE · Used equipment | $0.15 | $0.15 | $0.15 |
Blue Shield Setting Facility Modifier None Typical Low $0.48 Median $0.65 Typical High $0.95 | Facility | None | $0.48 | $0.65 | $0.95 |
Blue Shield Setting Professional Modifier None Typical Low $0.52 Median $0.81 Typical High $1.66 | Professional | None | $0.52 | $0.81 | $1.66 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.41 | Professional | None | $0.32 | $0.32 | $0.41 |
Cigna Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.45 Median $0.50 Typical High $0.62 | Professional | None | $0.45 | $0.50 | $0.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.41 Median $0.56 Typical High $128.82 | Professional | None | $0.41 | $0.56 | $128.82 |
Lucent Health Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $3.39 | Professional | None | $2.24 | $2.24 | $3.39 |
Molina Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | None | $0.44 | $0.44 | $0.44 |
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 $0.13 Median $0.42 Typical High $0.45 | Facility | None | $0.13 | $0.42 | $0.45 |
Providence Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
Sutter Health Plus Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | None | $0.83 | $0.83 | $0.83 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.20 Typical High $0.56 | Professional | None | $0.18 | $0.20 | $0.56 |
5 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 $0.06 Median $0.07 Typical High $0.13 | Professional | 52 · Reduced service | $0.06 | $0.07 | $0.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.04 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.50 Median $3.98 Typical High $9.12 | Professional | RR · Rental | $0.50 | $3.98 | $9.12 |
Where California sits
The same service costs 2.5 times more in Hawaii than in Utah. 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· 43rd of 51
$0.22
HI $0.48UT $0.19
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.