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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $14.13 | Professional | None | $12.88 | $12.88 | $14.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.79 Median $19.05 Typical High $77.62 | Facility | None | $14.79 | $19.05 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $42.66 | Professional | None | $15.14 | $15.14 | $42.66 |
Blue Shield Setting Professional Modifier None Typical Low $30.20 Median $46.77 Typical High $100.00 | Professional | None | $30.20 | $46.77 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $57.54 | Professional | None | $42.66 | $46.77 | $57.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $120.23 | Professional | None | $38.90 | $48.98 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | None | $281.84 | $281.84 | $323.59 |
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 $12.88 Median $42.66 Typical High $66.07 | Facility | None | $12.88 | $42.66 | $66.07 |
Providence Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $16.98 Median $18.20 Typical High $53.70 | Professional | None | $16.98 | $18.20 | $53.70 |
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 $6.46 Median $6.46 Typical High $12.88 | Professional | 52 · Reduced service | $6.46 | $6.46 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $5.13 | Professional | 53 · Discontinued | $2.57 | $2.57 | $5.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.55 Median $9.55 Typical High $19.05 | Professional | 54 · Surgery only | $9.55 | $9.55 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $3.80 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $2.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $4.17 Typical High $19.50 | Professional | RR · Rental | $3.24 | $4.17 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $31.62 Typical High $144.54 | Professional | UE · Used equipment | $23.99 | $31.62 | $144.54 |
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
$17.38
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.