How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $4Professionalmedian $1 · 10th to 90th $1 to $13
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 $0.66 Median $0.72 Typical High $0.76 | Facility | None | $0.66 | $0.72 | $0.76 |
Aetna Setting Professional Modifier None Typical Low $0.69 Median $0.76 Typical High $1.41 | Professional | None | $0.69 | $0.76 | $1.41 |
Ambetter Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.51 | Professional | None | $1.86 | $1.86 | $2.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.81 Median $1.02 Typical High $4.27 | Facility | None | $0.81 | $1.02 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $2.75 Typical High $3.63 | Professional | None | $1.10 | $2.75 | $3.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.10 Median $1.10 Typical High $2.82 | Professional | RR · Rental | $1.10 | $1.10 | $2.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | UE · Used equipment | $0.81 | $0.81 | $0.81 |
Blue Shield Setting Facility Modifier None Typical Low $2.57 Median $3.39 Typical High $5.13 | Facility | None | $2.57 | $3.39 | $5.13 |
Blue Shield Setting Professional Modifier None Typical Low $2.82 Median $4.57 Typical High $9.12 | Professional | None | $2.82 | $4.57 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $3.39 | Professional | None | $2.51 | $2.75 | $3.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.74 Median $2.88 Typical High $120.23 | Professional | None | $1.74 | $2.88 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $18.62 | Professional | None | $12.59 | $12.59 | $18.62 |
Molina Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
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 $0.72 Median $2.29 Typical High $2.51 | Facility | None | $0.72 | $2.29 | $2.51 |
Providence Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
United Setting Professional Modifier None Typical Low $0.98 Median $1.10 Typical High $3.16 | Professional | None | $0.98 | $1.10 | $3.16 |
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 $0.33 Median $0.36 Typical High $0.69 | Professional | 52 · Reduced service | $0.33 | $0.36 | $0.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.14 Typical High $0.27 | Professional | 53 · Discontinued | $0.13 | $0.14 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.11 Typical High $0.21 | Professional | 55 · Aftercare only | $0.10 | $0.11 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.14 |
Where California sits
The same service costs 2.6 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· 40th of 51
$1.26
HI $2.69UT $1.05
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.