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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $45.71 | Professional | None | $30.90 | $30.90 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $33.11 Typical High $138.04 | Facility | None | $26.30 | $33.11 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $75.86 | Professional | None | $26.30 | $26.30 | $75.86 |
Blue Shield Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $173.78 | Professional | None | $53.70 | $83.18 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $102.33 | Professional | None | $75.86 | $83.18 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $199.53 | Professional | None | $48.98 | $75.86 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | None | $562.34 | $676.08 | $676.08 |
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 $30.90 Median $75.86 Typical High $158.49 | Facility | None | $30.90 | $75.86 | $158.49 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $93.33 | Professional | None | $29.51 | $31.62 | $93.33 |
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 $15.49 Median $15.49 Typical High $22.39 | Professional | 52 · Reduced service | $15.49 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $9.12 | Professional | 53 · Discontinued | $6.17 | $6.17 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $23.44 Typical High $33.88 | Professional | 54 · Surgery only | $23.44 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $6.76 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $7.41 Typical High $34.67 | Professional | RR · Rental | $5.62 | $7.41 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $53.70 Typical High $257.04 | Professional | UE · Used equipment | $42.66 | $53.70 | $257.04 |
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
$30.90
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.