How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $6Professionalmedian $3 · 10th to 90th $1 to $37
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 $1.29 Median $1.41 Typical High $1.48 | Facility | None | $1.29 | $1.41 | $1.48 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.41 Typical High $2.09 | Professional | None | $1.29 | $1.41 | $2.09 |
Ambetter Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $4.27 | Professional | None | $3.31 | $3.63 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.78 Median $2.29 Typical High $9.33 | Facility | None | $1.78 | $2.29 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $3.31 Typical High $6.92 | Professional | None | $2.51 | $3.31 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.40 Median $2.40 Typical High $2.57 | Professional | RR · Rental | $2.40 | $2.40 | $2.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | UE · Used equipment | $1.82 | $1.82 | $1.82 |
Blue Shield Setting Facility Modifier None Typical Low $5.01 Median $6.61 Typical High $10.00 | Facility | None | $5.01 | $6.61 | $10.00 |
Blue Shield Setting Professional Modifier None Typical Low $5.37 Median $10.00 Typical High $17.78 | Professional | None | $5.37 | $10.00 | $17.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.89 Median $5.62 Typical High $5.75 | Professional | None | $3.89 | $5.62 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.09 | Facility | None | $2.95 | $2.95 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.89 Median $5.37 Typical High $5.89 | Professional | None | $3.89 | $5.37 | $5.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.95 Median $3.98 Typical High $11.22 | Professional | None | $2.95 | $3.98 | $11.22 |
Lucent Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $37.15 | Professional | None | $24.55 | $24.55 | $37.15 |
Molina Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
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 $1.38 Median $2.95 Typical High $4.90 | Facility | None | $1.38 | $2.95 | $4.90 |
Providence Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $6.03 | Professional | None | $1.91 | $2.24 | $6.03 |
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 $0.20 Median $0.21 Typical High $0.32 | Professional | 55 · Aftercare only | $0.20 | $0.21 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.14 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.13 | $0.14 | $0.21 |
Where California sits
The same service costs 5.5 times more in Kansas than in Delaware. 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
$2.95
KS $13.49DE $2.45
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.