How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $7Professionalmedian $3 · 10th to 90th $2 to $24
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 $1.26 Median $1.38 Typical High $1.45 | Facility | None | $1.26 | $1.38 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.38 Typical High $2.04 | Professional | None | $1.26 | $1.38 | $2.04 |
Ambetter Setting Professional Modifier None Typical Low $3.39 Median $4.07 Typical High $4.07 | Professional | None | $3.39 | $4.07 | $4.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.19 Median $2.82 Typical High $11.75 | Facility | None | $2.19 | $2.82 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.39 Typical High $6.61 | Professional | None | $3.02 | $3.39 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | RR · Rental | $3.02 | $3.02 | $3.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | UE · Used equipment | $2.24 | $2.24 | $2.24 |
Blue Shield Setting Facility Modifier None Typical Low $5.01 Median $6.61 Typical High $10.00 | Facility | None | $5.01 | $6.61 | $10.00 |
Blue Shield Setting Professional Modifier None Typical Low $5.25 Median $10.00 Typical High $17.78 | Professional | None | $5.25 | $10.00 | $17.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.14 Median $3.55 Typical High $8.91 | Professional | None | $2.14 | $3.55 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Facility | None | $2.69 | $2.82 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | None | $2.40 | $2.40 | $2.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.89 Median $5.37 Typical High $5.75 | Professional | None | $3.89 | $5.37 | $5.75 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.88 Median $3.98 Typical High $11.22 | Professional | None | $2.88 | $3.98 | $11.22 |
Lucent Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $36.31 | Professional | None | $23.99 | $23.99 | $36.31 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
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 $1.32 Median $2.82 Typical High $4.79 | Facility | None | $1.32 | $2.82 | $4.79 |
Providence Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | None | $2.40 | $2.40 | $2.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.29 Typical High $6.03 | Professional | None | $1.86 | $2.29 | $6.03 |
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 $0.63 Median $0.69 Typical High $1.07 | Professional | 52 · Reduced service | $0.63 | $0.69 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.28 Typical High $0.42 | Professional | 53 · Discontinued | $0.25 | $0.28 | $0.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.21 Typical High $0.31 | Professional | 55 · Aftercare only | $0.19 | $0.21 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.14 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.13 | $0.14 | $0.21 |
Where California sits
The same service costs 2.2 times more in Kansas than in New Jersey. 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· 23rd of 51
$3.09
KS $5.25NJ $2.40
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.