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 $0.34 Median $0.34 Typical High $0.71 | Facility | None | $0.34 | $0.34 | $0.71 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.39 | Professional | None | $0.34 | $0.34 | $0.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.35 Median $0.41 Typical High $0.50 | Facility | None | $0.35 | $0.41 | $0.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.42 | Professional | None | $0.35 | $0.35 | $0.42 |
Blue Shield Setting Facility Modifier None Typical Low $0.35 Median $0.36 Typical High $0.51 | Facility | None | $0.35 | $0.36 | $0.51 |
Blue Shield Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.41 | Professional | None | $0.34 | $0.34 | $0.41 |
Cigna Setting Facility Modifier None Typical Low $0.35 Median $0.71 Typical High $1.07 | Facility | None | $0.35 | $0.71 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $630.96 | Professional | None | $1.00 | $1.00 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Molina Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | None | $0.47 | $0.47 | $0.47 |
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 $0.34 Median $0.49 Typical High $0.93 | Facility | None | $0.34 | $0.49 | $0.93 |
Providence Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Sutter Health Plus Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
United Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.55 | Professional | None | $0.34 | $0.34 | $0.55 |
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 $0.17 Median $0.17 Typical High $0.17 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where California sits
The same service costs 1.6 times more in Montana than in Michigan. 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· 17th of 51
$0.35
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.