How much rates vary
Facilitymedian $6 · 10th to 90th $3 to $17Professionalmedian $4 · 10th to 90th $3 to $47
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 $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.69 Median $10.47 Typical High $20.42 | Facility | None | $2.69 | $10.47 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $4.47 Typical High $8.91 | Professional | None | $3.39 | $4.47 | $8.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | RR · Rental | $3.39 | $3.39 | $3.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | UE · Used equipment | $2.57 | $2.57 | $2.57 |
Blue Shield Setting Facility Modifier None Typical Low $6.03 Median $9.12 Typical High $15.14 | Facility | None | $6.03 | $9.12 | $15.14 |
Blue Shield Setting Professional Modifier None Typical Low $6.92 Median $12.88 Typical High $22.91 | Professional | None | $6.92 | $12.88 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.01 Median $6.92 Typical High $7.41 | Professional | None | $5.01 | $6.92 | $7.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.72 Median $5.62 Typical High $14.45 | Professional | None | $3.72 | $5.62 | $14.45 |
Lucent Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | None | $32.36 | $32.36 | $46.77 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
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 $1.86 Median $3.55 Typical High $6.31 | Facility | None | $1.86 | $3.55 | $6.31 |
Providence Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
United Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Facility | None | $6.46 | $6.46 | $7.59 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.39 Typical High $7.76 | Professional | None | $2.63 | $3.39 | $7.76 |
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 $1.70 Median $1.70 Typical High $1.70 | Professional | 52 · Reduced service | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.51 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.34 |
Where California sits
The same service costs 4.9 times more in Kansas 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· 22nd of 51
$3.98
KS $14.45DE $2.95
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.