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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $25.70 | Professional | None | $19.95 | $19.95 | $25.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $19.05 Typical High $79.43 | Facility | None | $15.14 | $19.05 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $43.65 | Professional | None | $15.49 | $15.49 | $43.65 |
Blue Shield Setting Professional Modifier None Typical Low $30.90 Median $47.86 Typical High $102.33 | Professional | None | $30.90 | $47.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $58.88 | Professional | None | $43.65 | $47.86 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $123.03 | Professional | None | $38.90 | $47.86 | $123.03 |
Lucent Health Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $436.52 | Professional | None | $323.59 | $436.52 | $436.52 |
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 $19.95 Median $43.65 Typical High $102.33 | Facility | None | $19.95 | $43.65 | $102.33 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
United Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $54.95 | Professional | None | $17.38 | $18.62 | $54.95 |
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 $10.00 Median $10.00 Typical High $13.18 | Professional | 52 · Reduced service | $10.00 | $10.00 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $5.25 | Professional | 53 · Discontinued | $3.98 | $3.98 | $5.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $14.79 Typical High $19.50 | Professional | 54 · Surgery only | $14.79 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.89 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $4.27 Typical High $19.95 | Professional | RR · Rental | $3.24 | $4.27 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $32.36 Typical High $147.91 | Professional | UE · Used equipment | $24.55 | $32.36 | $147.91 |
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
$19.95
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.