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 $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $12.02 | Professional | None | $7.59 | $7.59 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $8.91 Typical High $36.31 | Facility | None | $7.08 | $8.91 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $19.95 | Professional | None | $7.08 | $7.08 | $19.95 |
Blue Shield Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $46.77 | Professional | None | $14.13 | $21.88 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $26.92 | Professional | None | $19.95 | $21.88 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.20 Median $21.88 Typical High $56.23 | Professional | None | $18.20 | $21.88 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | None | $151.36 | $162.18 | $162.18 |
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 $7.59 Median $19.95 Typical High $38.02 | Facility | None | $7.59 | $19.95 | $38.02 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Professional Modifier None Typical Low $7.94 Median $8.51 Typical High $25.12 | Professional | None | $7.94 | $8.51 | $25.12 |
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 $3.80 Median $3.80 Typical High $6.03 | Professional | 52 · Reduced service | $3.80 | $3.80 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.51 Typical High $2.40 | Professional | 53 · Discontinued | $1.51 | $1.51 | $2.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.62 Median $5.62 Typical High $9.12 | Professional | 54 · Surgery only | $5.62 | $5.62 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $1.82 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $1.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.51 Median $1.95 Typical High $9.12 | Professional | RR · Rental | $1.51 | $1.95 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.22 Median $14.45 Typical High $69.18 | Professional | UE · Used equipment | $11.22 | $14.45 | $69.18 |
Where California sits
The same service costs 2.8 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· 49th of 51
$8.13
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.