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 $17.38 Median $19.05 Typical High $19.95 | Facility | None | $17.38 | $19.05 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $19.05 Typical High $25.12 | Professional | None | $18.20 | $19.05 | $25.12 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $25.12 Typical High $104.71 | Facility | None | $19.95 | $25.12 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $53.70 Typical High $70.79 | Professional | None | $26.30 | $53.70 | $70.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | RR · Rental | $26.92 | $26.92 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $87.10 Typical High $131.83 | Facility | None | $64.57 | $87.10 | $131.83 |
Blue Shield Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $177.83 | Professional | None | $60.26 | $93.33 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $66.07 | Professional | None | $48.98 | $53.70 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $63.10 Typical High $147.91 | Professional | None | $33.88 | $63.10 | $147.91 |
Lucent Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $371.54 | Professional | None | $245.47 | $245.47 | $371.54 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
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 $19.05 Median $48.98 Typical High $60.26 | Facility | None | $19.05 | $48.98 | $60.26 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $67.61 | Professional | None | $25.12 | $25.70 | $67.61 |
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 $2.63 Median $2.88 Typical High $4.37 | Professional | 55 · Aftercare only | $2.63 | $2.88 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.91 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.74 | $1.91 | $2.88 |
Where California sits
The same service costs 5.5 times more in Wyoming than in Utah. 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· 43rd of 51
$28.84
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.