How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $4Professionalmedian $2 · 10th to 90th $1 to $26
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 $0.91 Median $1.00 Typical High $1.05 | Facility | None | $0.91 | $1.00 | $1.05 |
Aetna Setting Professional Modifier None Typical Low $0.91 Median $1.00 Typical High $1.48 | Professional | None | $0.91 | $1.00 | $1.48 |
Ambetter Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.47 | Professional | None | $2.57 | $2.57 | $3.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.29 Median $1.62 Typical High $6.76 | Facility | None | $1.29 | $1.62 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $2.29 Typical High $4.27 | Professional | None | $1.74 | $2.29 | $4.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.74 Median $1.74 Typical High $1.82 | Professional | RR · Rental | $1.74 | $1.74 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.29 Median $1.32 Typical High $1.32 | Professional | UE · Used equipment | $1.29 | $1.32 | $1.32 |
Blue Shield Setting Facility Modifier None Typical Low $3.02 Median $3.98 Typical High $6.03 | Facility | None | $3.02 | $3.98 | $6.03 |
Blue Shield Setting Professional Modifier None Typical Low $3.24 Median $6.03 Typical High $10.72 | Professional | None | $3.24 | $6.03 | $10.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.12 Median $0.14 Typical High $2.34 | Professional | None | $0.12 | $0.14 | $2.34 |
Cigna Setting Facility Modifier None Typical Low $1.91 Median $2.04 Typical High $2.04 | Facility | None | $1.91 | $2.04 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.34 Median $3.24 Typical High $3.55 | Professional | None | $2.34 | $3.24 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.86 Median $2.63 Typical High $6.76 | Professional | None | $1.86 | $2.63 | $6.76 |
Lucent Health Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $25.70 | Professional | None | $18.20 | $18.20 | $25.70 |
Molina Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
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 $0.98 Median $2.04 Typical High $2.95 | Facility | None | $0.98 | $2.04 | $2.95 |
Providence Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $1.35 Median $1.51 Typical High $3.72 | Professional | None | $1.35 | $1.51 | $3.72 |
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 $0.14 Median $0.15 Typical High $0.22 | Professional | 55 · Aftercare only | $0.14 | $0.15 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.10 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.09 | $0.10 | $0.15 |
Where California sits
The same service costs 3.8 times more in Kansas than in Alabama. 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· 35th of 51
$1.86
KS $6.61AL $1.74
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.