How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 to $3
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 $0.79 Median $0.98 Typical High $1.78 | Facility | None | $0.79 | $0.98 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.87 Typical High $1.55 | Professional | None | $0.79 | $0.87 | $1.55 |
Ambetter Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.85 Median $0.98 Typical High $1.20 | Facility | None | $0.85 | $0.98 | $1.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.85 Median $0.87 Typical High $2.95 | Professional | None | $0.85 | $0.87 | $2.95 |
Blue Shield Setting Facility Modifier None Typical Low $1.05 Median $1.82 Typical High $2.45 | Facility | None | $1.05 | $1.82 | $2.45 |
Blue Shield Setting Professional Modifier None Typical Low $0.85 Median $1.05 Typical High $2.34 | Professional | None | $0.85 | $1.05 | $2.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.72 Median $0.87 Typical High $1.20 | Professional | None | $0.72 | $0.87 | $1.20 |
Cigna Setting Facility Modifier None Typical Low $0.83 Median $1.45 Typical High $2.00 | Facility | None | $0.83 | $1.45 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | None | $0.87 | $0.87 | $0.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.72 Median $1.00 Typical High $2.24 | Professional | None | $0.72 | $1.00 | $2.24 |
Lucent Health Setting Professional Modifier None Typical Low $1.32 Median $1.45 Typical High $2.63 | Professional | None | $1.32 | $1.45 | $2.63 |
Molina Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | None | $0.81 | $0.81 | $0.81 |
Providence Setting Facility Modifier None Typical Low $0.79 Median $1.51 Typical High $2.19 | Facility | None | $0.79 | $1.51 | $2.19 |
Providence Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.51 | Professional | None | $0.79 | $0.79 | $1.51 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
United Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Facility | None | $2.75 | $2.75 | $2.75 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $3.98 | Professional | None | $0.85 | $0.85 | $3.98 |
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 $0.40 Median $0.40 Typical High $0.40 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Where California sits
The same service costs 2.3 times more in Alaska 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· 13th of 51
$0.95
AK $1.82AL $0.79
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.