How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $2Professionalmedian $0 · 10th to 90th $0 to $7
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 $0.25 Median $0.28 Typical High $0.28 | Facility | None | $0.25 | $0.28 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.25 Median $0.28 Typical High $0.54 | Professional | None | $0.25 | $0.28 | $0.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.32 Median $0.40 Typical High $1.66 | Facility | None | $0.32 | $0.40 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.42 Median $1.00 Typical High $1.41 | Professional | None | $0.42 | $1.00 | $1.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | UE · Used equipment | $0.32 | $0.32 | $0.32 |
Blue Shield Setting Facility Modifier None Typical Low $1.00 Median $1.32 Typical High $2.00 | Facility | None | $1.00 | $1.32 | $2.00 |
Blue Shield Setting Professional Modifier None Typical Low $1.12 Median $1.78 Typical High $3.55 | Professional | None | $1.12 | $1.78 | $3.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $0.85 | Professional | None | $0.66 | $0.66 | $0.85 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.98 Median $1.07 Typical High $1.32 | Professional | None | $0.98 | $1.07 | $1.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.87 Median $1.15 Typical High $125.89 | Professional | None | $0.87 | $1.15 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $7.24 | Professional | None | $4.79 | $4.79 | $7.24 |
Molina Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | None | $0.95 | $0.95 | $0.95 |
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 $0.28 Median $0.87 Typical High $0.98 | Facility | None | $0.28 | $0.87 | $0.98 |
Providence Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.42 Typical High $1.20 | Professional | None | $0.38 | $0.42 | $1.20 |
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 $0.13 Median $0.14 Typical High $0.27 | Professional | 52 · Reduced service | $0.13 | $0.14 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.06 Typical High $0.11 | Professional | 53 · Discontinued | $0.05 | $0.06 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.08 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $7.08 Typical High $15.85 | Professional | RR · Rental | $1.07 | $7.08 | $15.85 |
Where California sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 37th of 51
$0.49
HI $1.05CO $0.41
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.