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 $22.39 Median $25.70 Typical High $29.51 | Facility | None | $22.39 | $25.70 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $25.70 Typical High $29.51 | Professional | None | $19.05 | $25.70 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $36.31 Typical High $151.36 | Facility | None | $28.84 | $36.31 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $1,445.44 | Professional | None | $29.51 | $42.66 | $1,445.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | RR · Rental | $38.90 | $38.90 | $46.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $36.31 | Professional | UE · Used equipment | $29.51 | $29.51 | $36.31 |
Blue Shield Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $128.82 | Professional | None | $60.26 | $87.10 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.88 Median $26.30 Typical High $26.30 | Professional | None | $21.88 | $26.30 | $26.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $63.10 | Professional | None | $22.91 | $22.91 | $63.10 |
Lucent Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | None | $194.98 | $194.98 | $234.42 |
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 $13.18 Median $27.54 Typical High $38.90 | Facility | None | $13.18 | $27.54 | $38.90 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
United Setting Professional Modifier None Typical Low $16.22 Median $17.38 Typical High $45.71 | Professional | None | $16.22 | $17.38 | $45.71 |
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 $9.55 Median $12.88 Typical High $14.79 | Professional | 52 · Reduced service | $9.55 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $5.13 Typical High $5.89 | Professional | 53 · Discontinued | $3.80 | $5.13 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.80 Typical High $4.47 | Professional | 55 · Aftercare only | $2.88 | $3.80 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.51 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.91 | $2.51 | $2.95 |
Where California sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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· 24th of 51
$25.70
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.