How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $4Professionalmedian $2 · 10th to 90th $1 to $22
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 $0.78 Median $0.85 Typical High $0.87 | Facility | None | $0.78 | $0.85 | $0.87 |
Aetna Setting Professional Modifier None Typical Low $0.78 Median $0.85 Typical High $1.26 | Professional | None | $0.78 | $0.85 | $1.26 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.95 | Professional | None | $2.04 | $2.04 | $2.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.35 Median $1.74 Typical High $7.08 | Facility | None | $1.35 | $1.74 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $2.04 Typical High $4.17 | Professional | None | $1.82 | $2.04 | $4.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | UE · Used equipment | $1.38 | $1.38 | $1.38 |
Blue Shield Setting Facility Modifier None Typical Low $3.02 Median $4.07 Typical High $6.17 | Facility | None | $3.02 | $4.07 | $6.17 |
Blue Shield Setting Professional Modifier None Typical Low $3.24 Median $6.03 Typical High $10.72 | Professional | None | $3.24 | $6.03 | $10.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.66 Median $2.40 Typical High $4.68 | Professional | None | $1.66 | $2.40 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Facility | None | $1.74 | $1.74 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.34 Median $3.24 Typical High $3.55 | Professional | None | $2.34 | $3.24 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.86 Median $2.63 Typical High $6.76 | Professional | None | $1.86 | $2.63 | $6.76 |
Lucent Health Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $21.88 | Professional | None | $14.79 | $14.79 | $21.88 |
Molina Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
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 $0.81 Median $1.74 Typical High $2.95 | Facility | None | $0.81 | $1.74 | $2.95 |
Providence Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.41 Typical High $3.72 | Professional | None | $1.15 | $1.41 | $3.72 |
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 $0.39 Median $0.43 Typical High $0.63 | Professional | 52 · Reduced service | $0.39 | $0.43 | $0.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.17 Typical High $0.26 | Professional | 53 · Discontinued | $0.15 | $0.17 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.13 Typical High $0.19 | Professional | 55 · Aftercare only | $0.12 | $0.13 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.09 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.08 | $0.09 | $0.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $1.82 Typical High $1.82 | Professional | RR · Rental | $0.18 | $1.82 | $1.82 |
Where California sits
The same service costs 2.2 times more in Kansas than in Alabama. 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
$1.78
KS $3.31AL $1.48
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.