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 $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $20.42 | Professional | None | $12.30 | $12.30 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.02 Median $15.14 Typical High $63.10 | Facility | None | $12.02 | $15.14 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $34.67 | Professional | None | $12.02 | $12.02 | $34.67 |
Blue Shield Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $79.43 | Professional | None | $24.55 | $38.02 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $46.77 | Professional | None | $34.67 | $38.02 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.91 Median $34.67 Typical High $95.50 | Professional | None | $22.91 | $34.67 | $95.50 |
Lucent Health Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | None | $257.04 | $269.15 | $269.15 |
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 $12.30 Median $34.67 Typical High $61.66 | Facility | None | $12.30 | $34.67 | $61.66 |
Providence Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $42.66 | Professional | None | $13.49 | $14.45 | $42.66 |
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 $6.17 Median $6.17 Typical High $10.23 | Professional | 52 · Reduced service | $6.17 | $6.17 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $4.17 | Professional | 53 · Discontinued | $2.45 | $2.45 | $4.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $9.12 Typical High $15.49 | Professional | 54 · Surgery only | $9.12 | $9.12 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $3.09 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $2.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.57 Median $3.39 Typical High $15.85 | Professional | RR · Rental | $2.57 | $3.39 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $24.55 Typical High $117.49 | Professional | UE · Used equipment | $19.50 | $24.55 | $117.49 |
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· 48th of 51
$14.13
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.