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 $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.94 Median $10.23 Typical High $41.69 | Facility | None | $7.94 | $10.23 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $6.92 Typical High $6.92 | Professional | None | $5.37 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.31 Median $10.96 Typical High $14.79 | Professional | RR · Rental | $6.31 | $10.96 | $14.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $8.13 Typical High $11.75 | Professional | UE · Used equipment | $4.79 | $8.13 | $11.75 |
Blue Shield Setting Facility Modifier None Typical Low $23.99 Median $32.36 Typical High $48.98 | Facility | None | $23.99 | $32.36 | $48.98 |
Blue Shield Setting Professional Modifier None Typical Low $19.05 Median $26.92 Typical High $40.74 | Professional | None | $19.05 | $26.92 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | None | $12.02 | $12.02 | $14.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $630.96 Typical High $831.76 | Professional | None | $141.25 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Providence Setting Facility Modifier None Typical Low $12.59 Median $14.13 Typical High $17.78 | Facility | None | $12.59 | $14.13 | $17.78 |
Providence Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | None | $12.02 | $12.02 | $14.13 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $21.88 | Professional | None | $9.77 | $12.59 | $21.88 |
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 $6.31 Median $6.31 Typical High $6.31 | Professional | 52 · Reduced service | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.26 | $1.26 | $1.26 |
Where California sits
The same service costs 2.7 times more in North Dakota than in Ohio. 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· 29th of 51
$12.59
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.