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 $6.92 Median $7.59 Typical High $7.94 | Facility | None | $6.92 | $7.59 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $10.96 | Professional | None | $6.92 | $7.59 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.94 Median $10.23 Typical High $42.66 | Facility | None | $7.94 | $10.23 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.22 Median $17.38 Typical High $36.31 | Professional | None | $11.22 | $17.38 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | RR · Rental | $10.96 | $10.96 | $11.48 |
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 $26.92 Median $36.31 Typical High $53.70 | Facility | None | $26.92 | $36.31 | $53.70 |
Blue Shield Setting Professional Modifier None Typical Low $28.84 Median $53.70 Typical High $95.50 | Professional | None | $28.84 | $53.70 | $95.50 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $20.89 Median $30.20 Typical High $30.90 | Professional | None | $20.89 | $30.20 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $16.98 | Facility | None | $15.49 | $15.49 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | None | $13.18 | $13.18 | $15.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $20.89 Median $28.84 Typical High $31.62 | Professional | None | $20.89 | $28.84 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.85 Median $18.20 Typical High $60.26 | Professional | None | $15.85 | $18.20 | $60.26 |
Lucent Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
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 $7.41 Median $15.49 Typical High $26.30 | Facility | None | $7.41 | $15.49 | $26.30 |
Providence Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | None | $13.18 | $13.18 | $15.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $10.23 Median $12.02 Typical High $32.36 | Professional | None | $10.23 | $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 $1.02 Median $1.12 Typical High $1.62 | Professional | 55 · Aftercare only | $1.02 | $1.12 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $0.76 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.69 | $0.76 | $1.10 |
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· 40th of 51
$13.18
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.