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 $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.76 | Professional | None | $7.24 | $7.24 | $7.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.46 Median $8.13 Typical High $33.88 | Facility | None | $6.46 | $8.13 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $18.20 | Professional | None | $6.46 | $6.46 | $18.20 |
Blue Shield Setting Professional Modifier None Typical Low $13.18 Median $20.42 Typical High $42.66 | Professional | None | $13.18 | $20.42 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $18.20 Median $20.42 Typical High $24.55 | Professional | None | $18.20 | $20.42 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.60 Median $22.91 Typical High $51.29 | Professional | None | $16.60 | $22.91 | $51.29 |
Lucent Health Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | None | $138.04 | $158.49 | $158.49 |
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 $7.24 Median $18.20 Typical High $36.31 | Facility | None | $7.24 | $18.20 | $36.31 |
Providence Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.76 Typical High $22.91 | Professional | None | $7.24 | $7.76 | $22.91 |
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 $3.63 Median $3.63 Typical High $5.50 | Professional | 52 · Reduced service | $3.63 | $3.63 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $2.19 | Professional | 53 · Discontinued | $1.45 | $1.45 | $2.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.37 Median $5.37 Typical High $8.32 | Professional | 54 · Surgery only | $5.37 | $5.37 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.66 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $1.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.38 Median $1.82 Typical High $8.32 | Professional | RR · Rental | $1.38 | $1.82 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $13.18 Typical High $63.10 | Professional | UE · Used equipment | $10.23 | $13.18 | $63.10 |
Where California sits
The same service costs 2.7 times more in Idaho 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
$7.59
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.