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 $0.91 Median $0.91 Typical High $0.91 | Facility | None | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.38 | Professional | None | $0.91 | $0.91 | $1.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $6.17 Typical High $25.70 | Facility | None | $4.90 | $6.17 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $5.37 Typical High $6.61 | Professional | None | $2.09 | $5.37 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | RR · Rental | $6.61 | $6.61 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | UE · Used equipment | $4.90 | $4.90 | $4.90 |
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 $0.87 Median $1.70 Typical High $1.70 | Professional | None | $0.87 | $1.70 | $1.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $7.94 Typical High $630.96 | Professional | None | $6.03 | $7.94 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | None | $17.38 | $18.20 | $18.20 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
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 $0.91 Median $2.63 Typical High $4.90 | Facility | None | $0.91 | $2.63 | $4.90 |
Providence Setting Professional Modifier None Typical Low $0.87 Median $1.70 Typical High $1.70 | Professional | None | $0.87 | $1.70 | $1.70 |
United Setting Professional Modifier None Typical Low $1.23 Median $1.29 Typical High $3.09 | Professional | None | $1.23 | $1.29 | $3.09 |
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 $0.14 Median $0.14 Typical High $0.20 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.14 |
Where California sits
The same service costs 6.6 times more in Kentucky than in West Virginia. 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· 30th of 51
$1.70
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.