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 $5.62 Median $6.03 Typical High $6.31 | Facility | None | $5.62 | $6.03 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $6.03 Typical High $6.46 | Professional | None | $5.62 | $6.03 | $6.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.76 Median $8.71 Typical High $36.31 | Facility | None | $6.76 | $8.71 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $13.80 Typical High $30.20 | Professional | None | $9.33 | $13.80 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | RR · Rental | $9.33 | $9.33 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | UE · Used equipment | $7.08 | $7.08 | $7.08 |
Blue Shield Setting Facility Modifier None Typical Low $21.88 Median $28.84 Typical High $43.65 | Facility | None | $21.88 | $28.84 | $43.65 |
Blue Shield Setting Professional Modifier None Typical Low $23.44 Median $43.65 Typical High $77.62 | Professional | None | $23.44 | $43.65 | $77.62 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $16.98 Median $17.38 Typical High $19.05 | Professional | None | $16.98 | $17.38 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $12.30 Typical High $12.30 | Facility | None | $11.22 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $25.12 | Professional | None | $16.98 | $23.44 | $25.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.59 Median $15.14 Typical High $48.98 | Professional | None | $12.59 | $15.14 | $48.98 |
Lucent Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $144.54 | Professional | None | $114.82 | $114.82 | $144.54 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
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 $5.89 Median $12.30 Typical High $20.89 | Facility | None | $5.89 | $12.30 | $20.89 |
Providence Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Sutter Health Plus Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $8.32 Median $9.55 Typical High $26.30 | Professional | None | $8.32 | $9.55 | $26.30 |
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 $0.83 Median $0.91 Typical High $1.23 | Professional | 55 · Aftercare only | $0.83 | $0.91 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.62 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.56 | $0.62 | $0.81 |
Where California sits
The same service costs 3.0 times more in Hawaii 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· 35th of 51
$11.22
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.