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 $50.12 Median $51.29 Typical High $58.88 | Facility | None | $50.12 | $51.29 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $58.88 | Professional | None | $34.67 | $51.29 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.85 Median $19.95 Typical High $81.28 | Facility | None | $15.85 | $19.95 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $44.67 | Professional | None | $15.85 | $15.85 | $44.67 |
Blue Shield Setting Professional Modifier None Typical Low $31.62 Median $48.98 Typical High $104.71 | Professional | None | $31.62 | $48.98 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Contra Costa Health Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $60.26 | Professional | None | $44.67 | $48.98 | $60.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $125.89 | Professional | None | $28.84 | $44.67 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | None | $338.84 | $407.38 | $407.38 |
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 $44.67 Median $53.70 Typical High $95.50 | Facility | None | $44.67 | $53.70 | $95.50 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Sutter Health Plus Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $56.23 | Professional | None | $17.78 | $19.05 | $56.23 |
7 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 $17.38 Median $25.70 Typical High $29.51 | Professional | 52 · Reduced service | $17.38 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $10.23 Typical High $12.02 | Professional | 53 · Discontinued | $6.92 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $38.02 Typical High $44.67 | Professional | 54 · Surgery only | $26.30 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $7.59 Typical High $8.91 | Professional | 55 · Aftercare only | $5.25 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.13 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.47 | $5.13 | $6.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.39 Median $4.37 Typical High $20.42 | Professional | RR · Rental | $3.39 | $4.37 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $33.11 Typical High $154.88 | Professional | UE · Used equipment | $25.12 | $33.11 | $154.88 |
Where California sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 48th of 51
$18.62
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.