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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.51 Median $10.72 Typical High $43.65 | Facility | None | $8.51 | $10.72 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $23.99 | Professional | None | $8.51 | $8.51 | $23.99 |
Blue Shield Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $56.23 | Professional | None | $16.98 | $26.30 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Contra Costa Health Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $32.36 | Professional | None | $23.99 | $26.30 | $32.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.85 Median $23.99 Typical High $67.61 | Professional | None | $15.85 | $23.99 | $67.61 |
Lucent Health Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $316.23 | Professional | None | $181.97 | $316.23 | $316.23 |
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 $14.45 Median $23.99 Typical High $74.13 | Facility | None | $14.45 | $23.99 | $74.13 |
Providence Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Sutter Health Plus Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $9.55 Median $10.23 Typical High $30.20 | Professional | None | $9.55 | $10.23 | $30.20 |
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 $7.24 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 54 · Surgery only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $2.34 Typical High $10.96 | Professional | RR · Rental | $1.82 | $2.34 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $17.38 Typical High $83.18 | Professional | UE · Used equipment | $13.49 | $17.38 | $83.18 |
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
$10.00
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.