How much rates vary
Facilitymedian $16 · 10th to 90th $12 to $62Professionalmedian $16 · 10th to 90th $12 to $251
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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $23.44 | Professional | None | $15.85 | $15.85 | $23.44 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $15.14 Typical High $61.66 | Facility | None | $11.75 | $15.14 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $33.88 | Professional | None | $12.02 | $12.02 | $33.88 |
Blue Shield Setting Professional Modifier None Typical Low $23.99 Median $37.15 Typical High $79.43 | Professional | None | $23.99 | $37.15 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $33.88 Median $37.15 Typical High $45.71 | Professional | None | $33.88 | $37.15 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $95.50 | Professional | None | $30.20 | $38.90 | $95.50 |
Lucent Health Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | None | $251.19 | $346.74 | $346.74 |
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 $15.85 Median $33.88 Typical High $81.28 | Facility | None | $15.85 | $33.88 | $81.28 |
Providence Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $42.66 | Professional | None | $13.49 | $14.45 | $42.66 |
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 $7.94 Median $7.94 Typical High $10.23 | Professional | 52 · Reduced service | $7.94 | $7.94 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $4.07 | Professional | 53 · Discontinued | $3.16 | $3.16 | $4.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $12.02 Typical High $15.14 | Professional | 54 · Surgery only | $12.02 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $3.02 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $2.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $3.31 Typical High $15.49 | Professional | RR · Rental | $2.51 | $3.31 | $15.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.05 Median $25.12 Typical High $114.82 | Professional | UE · Used equipment | $19.05 | $25.12 | $114.82 |
Where California sits
The same service costs 2.6 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· 47th of 51
$15.85
HI $35.48NY $13.49
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.