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 $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $9.12 | Professional | None | $6.61 | $6.61 | $9.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.02 Median $3.80 Typical High $15.49 | Facility | None | $3.02 | $3.80 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $8.51 | Professional | None | $3.02 | $3.02 | $8.51 |
Blue Shield Setting Professional Modifier None Typical Low $6.17 Median $9.33 Typical High $19.95 | Professional | None | $6.17 | $9.33 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $11.48 | Professional | None | $8.51 | $9.33 | $11.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $10.00 Typical High $28.84 | Professional | None | $7.76 | $10.00 | $28.84 |
Lucent Health Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $144.54 | Professional | None | $74.13 | $144.54 | $144.54 |
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 $6.61 Median $8.51 Typical High $33.88 | Facility | None | $6.61 | $8.51 | $33.88 |
Providence Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.63 Typical High $10.72 | Professional | None | $3.39 | $3.63 | $10.72 |
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 $3.31 Median $3.31 Typical High $3.31 | Professional | 52 · Reduced service | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | 53 · Discontinued | $1.32 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 54 · Surgery only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.66 | $0.66 | $0.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.65 Median $0.83 Typical High $3.89 | Professional | RR · Rental | $0.65 | $0.83 | $3.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $6.31 Typical High $29.51 | Professional | UE · Used equipment | $4.79 | $6.31 | $29.51 |
Where California sits
The same service costs 4.1 times more in Rhode Island 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· 29th of 51
$5.37
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.