How much rates vary
Facilitymedian $17 · 10th to 90th $10 to $21Professionalmedian $14 · 10th to 90th $8 to $89
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 $10.47 Median $12.02 Typical High $13.80 | Facility | None | $10.47 | $12.02 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $12.30 Typical High $16.60 | Professional | None | $10.47 | $12.30 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $39.81 Typical High $83.18 | Professional | None | $15.85 | $39.81 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.23 Median $13.18 Typical High $54.95 | Facility | None | $10.23 | $13.18 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $15.14 Typical High $676.08 | Professional | None | $13.49 | $15.14 | $676.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $14.13 Median $14.13 Typical High $14.45 | Professional | RR · Rental | $14.13 | $14.13 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.72 Median $10.72 Typical High $11.48 | Professional | UE · Used equipment | $10.72 | $10.72 | $11.48 |
Blue Shield Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $58.88 | Professional | None | $27.54 | $39.81 | $58.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | None | $75.86 | $75.86 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | RR · Rental | $2.09 | $2.09 | $2.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $91.20 | Professional | None | $75.86 | $91.20 | $91.20 |
HealthNet Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.20 Median $48.98 Typical High $630.96 | Professional | None | $30.20 | $48.98 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | None | $89.13 | $89.13 | $107.15 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
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 $6.17 Median $20.89 Typical High $20.89 | Facility | None | $6.17 | $20.89 | $20.89 |
Providence Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Providence Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | RR · Rental | $2.09 | $2.09 | $2.09 |
United Setting Professional Modifier None Typical Low $7.59 Median $7.94 Typical High $20.89 | Professional | None | $7.59 | $7.94 | $20.89 |
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 $4.37 Median $6.03 Typical High $6.92 | Professional | 52 · Reduced service | $4.37 | $6.03 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $2.40 Typical High $2.75 | Professional | 53 · Discontinued | $1.78 | $2.40 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $1.78 Typical High $2.09 | Professional | 55 · Aftercare only | $1.32 | $1.78 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.20 Typical High $1.38 | Professional | 56 · Pre-op care only | $0.87 | $1.20 | $1.38 |
Where California sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 20th of 51
$14.45
WY $53.70NC $8.71
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.