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 $0.31 Median $0.31 Typical High $0.31 | Facility | None | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.45 | Professional | None | $0.31 | $0.31 | $0.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.58 Median $2.00 Typical High $8.32 | Facility | None | $1.58 | $2.00 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.71 Median $0.98 Typical High $1.86 | Professional | None | $0.71 | $0.98 | $1.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | RR · Rental | $2.14 | $2.14 | $2.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | UE · Used equipment | $1.58 | $1.58 | $1.58 |
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 $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.00 Median $104.71 Typical High $630.96 | Professional | None | $2.00 | $104.71 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $5.89 Median $7.41 Typical High $7.41 | Professional | None | $5.89 | $7.41 | $7.41 |
Molina Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
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 $0.31 Median $0.87 Typical High $1.62 | Facility | None | $0.31 | $0.87 | $1.62 |
Providence Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
United Setting Professional Modifier None Typical Low $0.41 Median $0.43 Typical High $1.02 | Professional | None | $0.41 | $0.43 | $1.02 |
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 $0.05 Median $0.05 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Where California sits
The same service costs 190.5 times more in Wyoming than in Rhode Island. 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· 2nd of 51
$1.82
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.