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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | None | $4.79 | $4.79 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.00 Median $2.51 Typical High $10.47 | Facility | None | $2.00 | $2.51 | $10.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $3.24 Typical High $11.48 | Professional | None | $1.29 | $3.24 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $16.98 | Professional | RR · Rental | $2.69 | $2.69 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | UE · Used equipment | $2.04 | $2.04 | $2.04 |
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 $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
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 $2.24 Median $3.24 Typical High $120.23 | Professional | None | $2.24 | $3.24 | $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 $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
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 $2.51 Median $2.51 Typical High $6.92 | Facility | None | $2.51 | $2.51 | $6.92 |
Providence Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
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 $1.00 Median $1.15 Typical High $3.16 | Professional | None | $1.00 | $1.15 | $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 $1.07 Median $2.40 Typical High $2.40 | Professional | 52 · Reduced service | $1.07 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.95 Typical High $0.95 | Professional | 53 · Discontinued | $0.43 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.32 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.48 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.21 | $0.48 | $0.48 |
Where California sits
The same service costs 4.6 times more in Rhode Island 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· 13th of 51
$2.14
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.