How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $3Professionalmedian $1 · 10th to 90th $1 to $15
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 $0.52 Median $0.56 Typical High $0.60 | Facility | None | $0.52 | $0.56 | $0.60 |
Aetna Setting Professional Modifier None Typical Low $0.52 Median $0.56 Typical High $1.10 | Professional | None | $0.52 | $0.56 | $1.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.65 Median $0.81 Typical High $3.31 | Facility | None | $0.65 | $0.81 | $3.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.85 Median $2.19 Typical High $2.88 | Professional | None | $0.85 | $2.19 | $2.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | UE · Used equipment | $0.65 | $0.65 | $0.65 |
Blue Shield Setting Facility Modifier None Typical Low $2.04 Median $2.75 Typical High $4.17 | Facility | None | $2.04 | $2.75 | $4.17 |
Blue Shield Setting Professional Modifier None Typical Low $2.24 Median $3.63 Typical High $7.24 | Professional | None | $2.24 | $3.63 | $7.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.78 | Professional | None | $1.38 | $1.38 | $1.78 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.00 Median $2.19 Typical High $2.69 | Professional | None | $2.00 | $2.19 | $2.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $2.29 Typical High $125.89 | Professional | None | $1.00 | $2.29 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $14.79 | Professional | None | $10.00 | $10.00 | $14.79 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
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 $0.58 Median $1.82 Typical High $2.00 | Facility | None | $0.58 | $1.82 | $2.00 |
Providence Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
United Setting Professional Modifier None Typical Low $0.78 Median $0.87 Typical High $2.51 | Professional | None | $0.78 | $0.87 | $2.51 |
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 $0.26 Median $0.28 Typical High $0.55 | Professional | 52 · Reduced service | $0.26 | $0.28 | $0.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.11 Typical High $0.22 | Professional | 53 · Discontinued | $0.10 | $0.11 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.16 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.41 Median $2.24 Typical High $15.85 | Professional | RR · Rental | $1.41 | $2.24 | $15.85 |
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
$1.00
HI $2.14UT $0.83
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.