How much rates vary
Facilitymedian $6 · 10th to 90th $3 to $11Professionalmedian $6 · 10th to 90th $3 to $72
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 $2.75 Median $3.02 Typical High $3.16 | Facility | None | $2.75 | $3.02 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $3.02 Typical High $4.47 | Professional | None | $2.75 | $3.02 | $4.47 |
Ambetter Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $8.91 | Professional | None | $7.94 | $7.94 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $4.47 Typical High $18.62 | Facility | None | $3.47 | $4.47 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $7.08 Typical High $13.80 | Professional | None | $4.90 | $7.08 | $13.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $5.13 | Professional | RR · Rental | $4.79 | $4.79 | $5.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | UE · Used equipment | $3.63 | $3.63 | $3.63 |
Blue Shield Setting Facility Modifier None Typical Low $10.23 Median $13.80 Typical High $20.42 | Facility | None | $10.23 | $13.80 | $20.42 |
Blue Shield Setting Professional Modifier None Typical Low $10.96 Median $20.42 Typical High $36.31 | Professional | None | $10.96 | $20.42 | $36.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $7.94 Median $9.33 Typical High $9.33 | Professional | None | $7.94 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | None | $5.25 | $5.25 | $6.17 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $10.96 | Professional | None | $7.94 | $10.96 | $10.96 |
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 $51.29 Median $51.29 Typical High $72.44 | Professional | None | $51.29 | $51.29 | $72.44 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
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 $2.95 Median $6.17 Typical High $10.00 | Facility | None | $2.95 | $6.17 | $10.00 |
Providence Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | None | $5.25 | $5.25 | $6.17 |
Sutter Health Plus Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $4.07 Median $4.68 Typical High $12.30 | Professional | None | $4.07 | $4.68 | $12.30 |
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 $0.41 Median $0.45 Typical High $0.66 | Professional | 55 · Aftercare only | $0.41 | $0.45 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.30 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.28 | $0.30 | $0.44 |
Where California sits
The same service costs 2.1 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· 36th of 51
$6.03
HI $10.72CT $5.13
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.