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 $6.76 Median $7.41 Typical High $7.76 | Facility | None | $6.76 | $7.41 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $7.41 Typical High $10.47 | Professional | None | $6.76 | $7.41 | $10.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.76 Median $10.00 Typical High $41.69 | Facility | None | $7.76 | $10.00 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $16.98 Typical High $36.31 | Professional | None | $10.72 | $16.98 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | UE · Used equipment | $8.13 | $8.13 | $8.13 |
Blue Shield Setting Facility Modifier None Typical Low $26.30 Median $35.48 Typical High $53.70 | Facility | None | $26.30 | $35.48 | $53.70 |
Blue Shield Setting Professional Modifier None Typical Low $28.18 Median $52.48 Typical High $95.50 | Professional | None | $28.18 | $52.48 | $95.50 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $20.42 Median $20.89 Typical High $22.91 | Professional | None | $20.42 | $20.89 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $15.14 Typical High $15.14 | Facility | None | $14.79 | $15.14 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | None | $12.88 | $12.88 | $15.14 |
Contra Costa Health Setting Professional Modifier None Typical Low $20.42 Median $28.18 Typical High $30.90 | Professional | None | $20.42 | $28.18 | $30.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.22 Median $22.91 Typical High $58.88 | Professional | None | $16.22 | $22.91 | $58.88 |
Lucent Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | None | $147.91 | $147.91 | $162.18 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
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 $7.08 Median $15.14 Typical High $25.70 | Facility | None | $7.08 | $15.14 | $25.70 |
Providence Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | None | $12.88 | $12.88 | $15.14 |
Sutter Health Plus Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $32.36 | Professional | None | $10.00 | $12.02 | $32.36 |
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 $1.00 Median $1.12 Typical High $1.55 | Professional | 55 · Aftercare only | $1.00 | $1.12 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.74 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.68 | $0.74 | $0.93 |
Where California sits
The same service costs 3.5 times more in Hawaii than in Connecticut. 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
$15.14
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.