How much rates vary
Facilitymedian $8 · 10th to 90th $6 to $26Professionalmedian $8 · 10th to 90th $5 to $85
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 $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Ambetter Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.25 Median $21.38 Typical High $42.66 | Facility | None | $5.25 | $21.38 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $8.91 Typical High $18.20 | Professional | None | $6.61 | $8.91 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $6.92 | Professional | RR · Rental | $6.76 | $6.76 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | UE · Used equipment | $5.01 | $5.01 | $5.01 |
Blue Shield Setting Facility Modifier None Typical Low $12.59 Median $18.62 Typical High $30.90 | Facility | None | $12.59 | $18.62 | $30.90 |
Blue Shield Setting Professional Modifier None Typical Low $14.45 Median $26.92 Typical High $47.86 | Professional | None | $14.45 | $26.92 | $47.86 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $10.47 | Professional | None | $5.25 | $5.75 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.25 Median $12.88 Typical High $14.45 | Professional | None | $5.25 | $12.88 | $14.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $10.96 Typical High $30.20 | Professional | None | $7.76 | $10.96 | $30.20 |
Lucent Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $85.11 | Professional | None | $74.13 | $74.13 | $85.11 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
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 $3.63 Median $7.08 Typical High $12.88 | Facility | None | $3.63 | $7.08 | $12.88 |
Providence Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $7.94 | Facility | None | $6.31 | $7.94 | $7.94 |
United Setting Professional Modifier None Typical Low $5.25 Median $6.61 Typical High $16.22 | Professional | None | $5.25 | $6.61 | $16.22 |
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 $3.31 Median $3.31 Typical High $3.31 | Professional | 52 · Reduced service | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | 53 · Discontinued | $1.32 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.66 | $0.66 | $0.66 |
Where California sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 26th of 51
$7.94
MT $15.49KS $4.37
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.