How much rates vary
Facilitymedian $6 · 10th to 90th $3 to $11Professionalmedian $6 · 10th to 90th $3 to $74
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 $2.63 Median $2.88 Typical High $3.02 | Facility | None | $2.63 | $2.88 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $2.88 Typical High $4.37 | Professional | None | $2.63 | $2.88 | $4.37 |
Ambetter Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.09 Median $3.98 Typical High $16.22 | Facility | None | $3.09 | $3.98 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.80 Median $6.92 Typical High $14.13 | Professional | None | $3.80 | $6.92 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.80 Median $4.17 Typical High $4.17 | Professional | RR · Rental | $3.80 | $4.17 | $4.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.88 Median $3.16 Typical High $3.16 | Professional | UE · Used equipment | $2.88 | $3.16 | $3.16 |
Blue Shield Setting Facility Modifier None Typical Low $10.23 Median $13.80 Typical High $20.89 | Facility | None | $10.23 | $13.80 | $20.89 |
Blue Shield Setting Professional Modifier None Typical Low $10.96 Median $20.42 Typical High $37.15 | Professional | None | $10.96 | $20.42 | $37.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.89 | Professional | None | $5.01 | $5.01 | $5.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $12.02 | Professional | None | $7.94 | $10.96 | $12.02 |
HealthNet Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $8.51 Typical High $22.91 | Professional | None | $6.03 | $8.51 | $22.91 |
Lucent Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $74.13 | Professional | None | $50.12 | $50.12 | $74.13 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
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 $2.82 Median $5.89 Typical High $10.00 | Facility | None | $2.82 | $5.89 | $10.00 |
Providence Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.89 | Professional | None | $5.01 | $5.01 | $5.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $3.89 Median $4.68 Typical High $12.59 | Professional | None | $3.89 | $4.68 | $12.59 |
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 $0.39 Median $0.43 Typical High $0.66 | Professional | 55 · Aftercare only | $0.39 | $0.43 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.28 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.26 | $0.28 | $0.43 |
Where California sits
The same service costs 2.4 times more in Kansas 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· 28th of 51
$5.89
KS $10.96CT $4.57
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.