How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $3Professionalmedian $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 $1.00 Median $1.00 Typical High $2.04 | Facility | None | $1.00 | $1.00 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.12 Typical High $2.14 | Professional | None | $1.00 | $1.12 | $2.14 |
Ambetter Setting Professional Modifier None Typical Low $1.00 Median $2.04 Typical High $2.88 | Professional | None | $1.00 | $2.04 | $2.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.89 Median $1.10 Typical High $1.48 | Facility | None | $0.89 | $1.10 | $1.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $5.25 | Professional | None | $0.89 | $0.89 | $5.25 |
Blue Shield Setting Facility Modifier None Typical Low $1.32 Median $1.82 Typical High $2.57 | Facility | None | $1.32 | $1.82 | $2.57 |
Blue Shield Setting Professional Modifier None Typical Low $2.04 Median $2.40 Typical High $4.47 | Professional | None | $2.04 | $2.40 | $4.47 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.89 Median $1.10 Typical High $1.48 | Professional | None | $0.89 | $1.10 | $1.48 |
Cigna Setting Facility Modifier None Typical Low $1.02 Median $1.82 Typical High $2.51 | Facility | None | $1.02 | $1.82 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | None | $0.93 | $0.93 | $0.93 |
HealthNet Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.89 Median $1.07 Typical High $2.82 | Professional | None | $0.89 | $1.07 | $2.82 |
Lucent Health Setting Professional Modifier None Typical Low $1.38 Median $2.19 Typical High $2.82 | Professional | None | $1.38 | $2.19 | $2.82 |
Molina Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Providence Setting Facility Modifier None Typical Low $1.00 Median $1.86 Typical High $2.82 | Facility | None | $1.00 | $1.86 | $2.82 |
Providence Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $2.14 | Professional | None | $1.00 | $1.00 | $2.14 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
United Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
United Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $3.02 | Professional | None | $0.89 | $0.89 | $3.02 |
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 $0.50 Median $0.51 Typical High $0.51 | Professional | 52 · Reduced service | $0.50 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Where California sits
The same service costs 2.5 times more in Texas than in Maryland. 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
$1.12
TX $2.19MD $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.