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 $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.89 | Professional | None | $2.63 | $2.63 | $3.89 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.01 Median $6.31 Typical High $26.30 | Facility | None | $5.01 | $6.31 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $6.76 Typical High $8.32 | Professional | None | $5.75 | $6.76 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | RR · Rental | $6.76 | $6.76 | $6.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | UE · Used equipment | $5.13 | $5.13 | $5.13 |
Blue Shield Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.96 Median $14.13 Typical High $630.96 | Professional | None | $10.96 | $14.13 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | None | $45.71 | $45.71 | $48.98 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
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 $2.63 Median $7.41 Typical High $13.80 | Facility | None | $2.63 | $7.41 | $13.80 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.72 Typical High $8.71 | Professional | None | $3.31 | $3.72 | $8.71 |
2 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 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $0.58 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.39 |
Where California sits
The same service costs 3.2 times more in Montana than in Colorado. 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· 20th of 51
$4.79
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.