How much rates vary
Facilitymedian $5 · 10th to 90th $5 to $21Professionalmedian $6 · 10th to 90th $4 to $62
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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $7.41 Typical High $8.71 | Professional | None | $6.17 | $7.41 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $18.20 Typical High $35.48 | Facility | None | $3.80 | $18.20 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $6.17 Typical High $15.14 | Professional | None | $4.90 | $6.17 | $15.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | RR · Rental | $4.90 | $4.90 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | UE · Used equipment | $3.63 | $3.63 | $3.63 |
Blue Shield Setting Facility Modifier None Typical Low $10.47 Median $15.85 Typical High $26.30 | Facility | None | $10.47 | $15.85 | $26.30 |
Blue Shield Setting Professional Modifier None Typical Low $12.02 Median $22.39 Typical High $39.81 | Professional | None | $12.02 | $22.39 | $39.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.47 Median $4.90 Typical High $8.71 | Professional | None | $4.47 | $4.90 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | None | $3.80 | $3.80 | $5.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.47 Median $10.96 Typical High $12.02 | Professional | None | $4.47 | $10.96 | $12.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.46 Median $9.77 Typical High $25.12 | Professional | None | $6.46 | $9.77 | $25.12 |
Lucent Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $61.66 | Professional | None | $53.70 | $53.70 | $61.66 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
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 $2.63 Median $5.13 Typical High $10.96 | Facility | None | $2.63 | $5.13 | $10.96 |
Providence Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | None | $3.80 | $3.80 | $5.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
United Setting Facility Modifier None Typical Low $4.79 Median $5.37 Typical High $5.37 | Facility | None | $4.79 | $5.37 | $5.37 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.37 Typical High $13.49 | Professional | None | $3.80 | $5.37 | $13.49 |
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 $2.40 Median $2.40 Typical High $2.40 | Professional | 52 · Reduced service | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 53 · Discontinued | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $0.48 |
Where California sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 27th of 51
$5.37
HI $12.02DE $3.80
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.