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 $181.97 Median $398.11 Typical High $398.11 | Facility | None | $181.97 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $398.11 | Professional | None | $117.49 | $181.97 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $53.70 Typical High $223.87 | Facility | None | $41.69 | $53.70 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $58.88 | Professional | None | $39.81 | $57.54 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | RR · Rental | $57.54 | $57.54 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Blue Shield Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $147.91 | Professional | None | $69.18 | $100.00 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $630.96 | Professional | None | $93.33 | $123.03 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $21.88 Median $181.97 Typical High $398.11 | Facility | None | $21.88 | $181.97 | $398.11 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $54.95 Median $91.20 Typical High $199.53 | Professional | 52 · Reduced service | $54.95 | $91.20 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $36.31 Typical High $79.43 | Professional | 53 · Discontinued | $21.88 | $36.31 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $27.54 Typical High $60.26 | Professional | 55 · Aftercare only | $16.22 | $27.54 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $18.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $10.96 | $18.20 | $39.81 |
Where California sits
The same service costs 26.3 times more in Rhode Island than in South 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· 3rd of 51
$229
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.