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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $21.38 Typical High $87.10 | Facility | None | $16.98 | $21.38 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $47.86 | Professional | None | $16.98 | $16.98 | $47.86 |
Blue Shield Setting Professional Modifier None Typical Low $33.88 Median $52.48 Typical High $112.20 | Professional | None | $33.88 | $52.48 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $64.57 | Professional | None | $47.86 | $52.48 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $131.83 | Professional | None | $32.36 | $47.86 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $630.96 | Professional | None | $363.08 | $630.96 | $630.96 |
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 $28.84 Median $47.86 Typical High $147.91 | Facility | None | $28.84 | $47.86 | $147.91 |
Providence Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Sutter Health Plus Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $19.05 Median $20.42 Typical High $60.26 | Professional | None | $19.05 | $20.42 | $60.26 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 54 · Surgery only | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $4.79 Typical High $21.88 | Professional | RR · Rental | $3.63 | $4.79 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.92 Median $34.67 Typical High $165.96 | Professional | UE · Used equipment | $26.92 | $34.67 | $165.96 |
Where California sits
The same service costs 3.2 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· 49th of 51
$19.95
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.