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 $3.09 Median $3.09 Typical High $3.09 | Facility | None | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $4.47 | Professional | None | $3.09 | $3.09 | $4.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.57 Median $3.24 Typical High $13.49 | Facility | None | $2.57 | $3.24 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $7.41 | Professional | None | $2.63 | $2.63 | $7.41 |
Blue Shield Setting Professional Modifier None Typical Low $5.25 Median $8.13 Typical High $17.38 | Professional | None | $5.25 | $8.13 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.41 Median $8.13 Typical High $10.00 | Professional | None | $7.41 | $8.13 | $10.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.61 Median $7.59 Typical High $20.42 | Professional | None | $6.61 | $7.59 | $20.42 |
Lucent Health Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | None | $54.95 | $66.07 | $66.07 |
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 $3.09 Median $7.41 Typical High $15.49 | Facility | None | $3.09 | $7.41 | $15.49 |
Providence Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $2.95 Median $3.16 Typical High $9.12 | Professional | None | $2.95 | $3.16 | $9.12 |
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 $1.51 Median $1.51 Typical High $2.19 | Professional | 52 · Reduced service | $1.51 | $1.51 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.87 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.29 Median $2.29 Typical High $3.31 | Professional | 54 · Surgery only | $2.29 | $2.29 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.66 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.43 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.55 Median $0.72 Typical High $3.39 | Professional | RR · Rental | $0.55 | $0.72 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.89 Median $5.25 Typical High $25.12 | Professional | UE · Used equipment | $3.89 | $5.25 | $25.12 |
Where California sits
The same service costs 2.7 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· 46th of 51
$3.09
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.