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 $0.81 Median $0.89 Typical High $0.93 | Facility | None | $0.81 | $0.89 | $0.93 |
Aetna Setting Professional Modifier None Typical Low $0.81 Median $0.89 Typical High $1.35 | Professional | None | $0.81 | $0.89 | $1.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.00 Median $1.29 Typical High $5.37 | Facility | None | $1.00 | $1.29 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $2.19 Typical High $4.47 | Professional | None | $1.38 | $2.19 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | RR · Rental | $1.38 | $1.38 | $1.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | UE · Used equipment | $1.05 | $1.05 | $1.05 |
Blue Shield Setting Facility Modifier None Typical Low $3.24 Median $4.27 Typical High $6.46 | Facility | None | $3.24 | $4.27 | $6.46 |
Blue Shield Setting Professional Modifier None Typical Low $3.47 Median $6.46 Typical High $11.75 | Professional | None | $3.47 | $6.46 | $11.75 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.51 Median $9.33 Typical High $9.33 | Professional | None | $2.51 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.04 | Facility | None | $1.86 | $1.86 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.86 | Professional | None | $1.58 | $1.58 | $1.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.51 Median $3.47 Typical High $3.80 | Professional | None | $2.51 | $3.47 | $3.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.91 Median $2.69 Typical High $7.24 | Professional | None | $1.91 | $2.69 | $7.24 |
Lucent Health Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $23.44 | Professional | None | $18.20 | $18.20 | $23.44 |
Molina Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
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 $0.87 Median $1.86 Typical High $3.16 | Facility | None | $0.87 | $1.86 | $3.16 |
Providence Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.86 | Professional | None | $1.58 | $1.58 | $1.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
United Setting Professional Modifier None Typical Low $1.23 Median $1.48 Typical High $3.98 | Professional | None | $1.23 | $1.48 | $3.98 |
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 $0.12 Median $0.14 Typical High $0.21 | Professional | 55 · Aftercare only | $0.12 | $0.14 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.09 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.08 | $0.09 | $0.14 |
Where California sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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· 33rd of 51
$1.86
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.