How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $6Professionalmedian $2 · 10th to 90th $2 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 $2.04 Median $2.82 Typical High $5.25 | Facility | None | $2.04 | $2.82 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $3.02 | Professional | None | $2.04 | $2.19 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $3.98 | Professional | None | $2.04 | $2.04 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.14 Median $2.45 Typical High $3.02 | Facility | None | $2.14 | $2.45 | $3.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.39 | Professional | None | $2.14 | $2.14 | $3.39 |
Blue Shield Setting Facility Modifier None Typical Low $2.63 Median $5.25 Typical High $6.17 | Facility | None | $2.63 | $5.25 | $6.17 |
Blue Shield Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.75 | Professional | None | $2.19 | $2.19 | $2.75 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $2.24 | Professional | None | $2.04 | $2.24 | $2.24 |
Cigna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.63 | Professional | None | $2.09 | $2.09 | $2.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.95 Median $2.00 Typical High $2.34 | Professional | None | $1.95 | $2.00 | $2.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.86 Median $2.04 Typical High $3.98 | Professional | None | $1.86 | $2.04 | $3.98 |
Lucent Health Setting Professional Modifier None Typical Low $1.95 Median $2.69 Typical High $5.25 | Professional | None | $1.95 | $2.69 | $5.25 |
Molina Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Providence Setting Facility Modifier None Typical Low $1.91 Median $2.14 Typical High $4.47 | Facility | None | $1.91 | $2.14 | $4.47 |
Providence Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $3.89 | Professional | None | $2.57 | $2.82 | $3.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $3.24 | Professional | None | $2.04 | $2.19 | $3.24 |
9 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 Facility Modifier 52 · Reduced service Typical Low $1.00 Median $1.62 Typical High $2.69 | Facility | 52 · Reduced service | $1.00 | $1.62 | $2.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.40 Median $0.65 Typical High $1.07 | Facility | 53 · Discontinued | $0.40 | $0.65 | $1.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.30 Median $0.48 Typical High $0.81 | Facility | 55 · Aftercare only | $0.30 | $0.48 | $0.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.32 Typical High $0.54 | Facility | 56 · Pre-op care only | $0.20 | $0.32 | $0.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.00 Median $1.02 Typical High $1.02 | Professional | 52 · Reduced service | $1.00 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.41 Typical High $0.41 | Professional | 53 · Discontinued | $0.40 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.30 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | JZ · No drug discarded | $2.04 | $2.04 | $2.04 |
Where California sits
The same service costs 2.1 times more in Wyoming than in Delaware. 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· 17th of 51
$2.19
WY $4.37DE $2.04
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.