How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $7Professionalmedian $4 · 10th to 90th $2 to $219
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 $1.82 Median $2.04 Typical High $2.09 | Facility | None | $1.82 | $2.04 | $2.09 |
Aetna Setting Professional Modifier None Typical Low $1.82 Median $2.04 Typical High $3.02 | Professional | None | $1.82 | $2.04 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.29 Median $2.88 Typical High $12.02 | Facility | None | $2.29 | $2.88 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $4.90 Typical High $10.00 | Professional | None | $3.09 | $4.90 | $10.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | RR · Rental | $3.09 | $3.09 | $3.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | UE · Used equipment | $2.34 | $2.34 | $2.34 |
Blue Shield Setting Facility Modifier None Typical Low $7.24 Median $9.55 Typical High $14.45 | Facility | None | $7.24 | $9.55 | $14.45 |
Blue Shield Setting Professional Modifier None Typical Low $7.76 Median $14.45 Typical High $25.70 | Professional | None | $7.76 | $14.45 | $25.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $6.31 | Professional | None | $5.62 | $5.75 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $4.17 Typical High $4.17 | Facility | None | $3.98 | $4.17 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.62 Median $7.76 Typical High $8.32 | Professional | None | $5.62 | $7.76 | $8.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.17 Median $6.03 Typical High $16.22 | Professional | None | $4.17 | $6.03 | $16.22 |
Lucent Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $218.78 | Professional | None | $34.67 | $34.67 | $218.78 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $33.11 | Professional | None | $6.92 | $6.92 | $33.11 |
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 $1.95 Median $4.17 Typical High $7.08 | Facility | None | $1.95 | $4.17 | $7.08 |
Providence Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $2.75 Median $3.24 Typical High $8.71 | Professional | None | $2.75 | $3.24 | $8.71 |
3 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 $0.28 Median $0.30 Typical High $0.47 | Professional | 55 · Aftercare only | $0.28 | $0.30 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.20 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.18 | $0.20 | $0.30 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | KX · Policy requirements met | $4.90 | $4.90 | $4.90 |
Where California sits
The same service costs 2.1 times more in Idaho 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· 26th of 51
$4.17
ID $7.24CT $3.39
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.