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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $20.89 Typical High $20.89 | Professional | None | $10.96 | $20.89 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $36.31 Typical High $77.62 | Facility | None | $26.92 | $36.31 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $380.19 | Professional | None | $10.96 | $16.60 | $380.19 |
Blue Shield Setting Facility Modifier None Typical Low $13.49 Median $21.38 Typical High $45.71 | Facility | None | $13.49 | $21.38 | $45.71 |
Blue Shield Setting Professional Modifier None Typical Low $7.94 Median $11.48 Typical High $13.18 | Professional | None | $7.94 | $11.48 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $9.77 Median $19.50 Typical High $29.51 | Facility | None | $9.77 | $19.50 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $100.00 | Professional | None | $74.13 | $100.00 | $100.00 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
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 $9.77 Median $20.89 Typical High $30.20 | Facility | None | $9.77 | $20.89 | $30.20 |
Providence Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $45.71 | Facility | None | $20.89 | $20.89 | $45.71 |
United Setting Professional Modifier None Typical Low $5.75 Median $7.41 Typical High $16.98 | Professional | None | $5.75 | $7.41 | $16.98 |
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 $5.50 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $5.50 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $2.29 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $1.74 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.17 | $2.09 | $2.09 |
Where California sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 16th of 51
$9.77
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.