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 $29.51 Median $33.11 Typical High $38.90 | Facility | None | $29.51 | $33.11 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $38.90 | Professional | None | $24.55 | $33.11 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $50.12 Typical High $204.17 | Facility | None | $38.90 | $50.12 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $53.70 | Professional | None | $36.31 | $50.12 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $50.12 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $39.81 Typical High $47.86 | Professional | UE · Used equipment | $38.02 | $39.81 | $47.86 |
Blue Shield Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $169.82 | Professional | None | $79.43 | $112.20 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Contra Costa Health Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $51.29 | Professional | None | $42.66 | $51.29 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $77.62 | Professional | None | $44.67 | $67.61 | $77.62 |
Lucent Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | None | $251.19 | $251.19 | $302.00 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $17.38 Median $30.20 Typical High $50.12 | Facility | None | $17.38 | $30.20 | $50.12 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
United Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $58.88 | Professional | None | $21.38 | $22.39 | $58.88 |
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 $12.30 Median $16.60 Typical High $19.50 | Professional | 52 · Reduced service | $12.30 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.76 Typical High $7.76 | Professional | 53 · Discontinued | $4.90 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $5.01 Typical High $5.89 | Professional | 55 · Aftercare only | $3.72 | $5.01 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.39 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.45 | $3.39 | $3.89 |
Where California sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 22nd of 51
$33.11
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.