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 $0.48 Median $0.52 Typical High $0.55 | Facility | None | $0.48 | $0.52 | $0.55 |
Aetna Setting Professional Modifier None Typical Low $0.48 Median $0.52 Typical High $1.00 | Professional | None | $0.48 | $0.52 | $1.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.58 Median $0.74 Typical High $3.02 | Facility | None | $0.58 | $0.74 | $3.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $2.34 Typical High $2.57 | Professional | None | $0.79 | $2.34 | $2.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | UE · Used equipment | $0.59 | $0.59 | $0.59 |
Blue Shield Setting Facility Modifier None Typical Low $1.86 Median $2.51 Typical High $3.80 | Facility | None | $1.86 | $2.51 | $3.80 |
Blue Shield Setting Professional Modifier None Typical Low $2.04 Median $3.24 Typical High $6.61 | Professional | None | $2.04 | $3.24 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.78 Median $1.95 Typical High $2.40 | Professional | None | $1.78 | $1.95 | $2.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.62 Median $2.14 Typical High $120.23 | Professional | None | $1.62 | $2.14 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $13.49 | Professional | None | $8.91 | $8.91 | $13.49 |
Molina Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
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 $0.52 Median $1.66 Typical High $1.78 | Facility | None | $0.52 | $1.66 | $1.78 |
Providence Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.79 Typical High $2.24 | Professional | None | $0.71 | $0.79 | $2.24 |
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 $0.24 Median $0.26 Typical High $0.50 | Professional | 52 · Reduced service | $0.24 | $0.26 | $0.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.20 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.08 Typical High $0.15 | Professional | 55 · Aftercare only | $0.07 | $0.08 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.70 Median $2.09 Typical High $31.62 | Professional | RR · Rental | $1.70 | $2.09 | $31.62 |
Where California sits
The same service costs 2.5 times more in Idaho 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· 45th of 51
$0.89
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.