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 $2.19 Median $2.40 Typical High $2.51 | Facility | None | $2.19 | $2.40 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $2.51 Typical High $4.68 | Professional | None | $2.34 | $2.51 | $4.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.69 Median $3.47 Typical High $14.13 | Facility | None | $2.69 | $3.47 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $9.33 Typical High $12.30 | Professional | None | $3.63 | $9.33 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | UE · Used equipment | $2.75 | $2.75 | $2.75 |
Blue Shield Setting Facility Modifier None Typical Low $8.71 Median $11.48 Typical High $17.38 | Facility | None | $8.71 | $11.48 | $17.38 |
Blue Shield Setting Professional Modifier None Typical Low $9.55 Median $15.14 Typical High $30.90 | Professional | None | $9.55 | $15.14 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $8.32 Median $9.33 Typical High $11.22 | Professional | None | $8.32 | $9.33 | $11.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $9.55 Typical High $120.23 | Professional | None | $6.03 | $9.55 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $63.10 | Professional | None | $41.69 | $41.69 | $63.10 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
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 $2.40 Median $7.76 Typical High $8.32 | Facility | None | $2.40 | $7.76 | $8.32 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.72 Typical High $10.47 | Professional | None | $3.31 | $3.72 | $10.47 |
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 $1.12 Median $1.20 Typical High $2.34 | Professional | 52 · Reduced service | $1.12 | $1.20 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.48 Typical High $0.93 | Professional | 53 · Discontinued | $0.44 | $0.48 | $0.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.36 Typical High $0.71 | Professional | 55 · Aftercare only | $0.33 | $0.36 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.24 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.22 | $0.24 | $0.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $9.55 Typical High $40.74 | Professional | RR · Rental | $6.03 | $9.55 | $40.74 |
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· 39th of 51
$4.27
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.