How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $6Professionalmedian $3 · 10th to 90th $2 to $39
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 $1.38 Median $1.51 Typical High $1.55 | Facility | None | $1.38 | $1.51 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.51 Typical High $2.24 | Professional | None | $1.38 | $1.51 | $2.24 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $3.89 Typical High $5.25 | Professional | None | $3.80 | $3.89 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.86 Median $2.40 Typical High $9.77 | Facility | None | $1.86 | $2.40 | $9.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $3.63 Typical High $7.24 | Professional | None | $2.63 | $3.63 | $7.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | RR · Rental | $2.57 | $2.57 | $2.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | UE · Used equipment | $1.91 | $1.91 | $1.91 |
Blue Shield Setting Facility Modifier None Typical Low $5.25 Median $7.08 Typical High $10.72 | Facility | None | $5.25 | $7.08 | $10.72 |
Blue Shield Setting Professional Modifier None Typical Low $5.62 Median $10.47 Typical High $19.05 | Professional | None | $5.62 | $10.47 | $19.05 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.21 Median $0.23 Typical High $4.07 | Professional | None | $0.21 | $0.23 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.24 | Facility | None | $3.09 | $3.09 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.09 | Professional | None | $2.57 | $2.57 | $3.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.07 Median $5.62 Typical High $6.17 | Professional | None | $4.07 | $5.62 | $6.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.09 Median $4.07 Typical High $11.75 | Professional | None | $3.09 | $4.07 | $11.75 |
Lucent Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $38.90 | Professional | None | $25.70 | $25.70 | $38.90 |
Molina Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
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 $1.48 Median $3.09 Typical High $5.13 | Facility | None | $1.48 | $3.09 | $5.13 |
Providence Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.09 | Professional | None | $2.57 | $2.57 | $3.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.40 Typical High $6.46 | Professional | None | $2.04 | $2.40 | $6.46 |
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 $0.21 Median $0.23 Typical High $0.35 | Professional | 55 · Aftercare only | $0.21 | $0.23 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.15 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.14 | $0.15 | $0.22 |
Where California sits
The same service costs 3.2 times more in Kansas than in Missouri. 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
$3.02
KS $8.13MO $2.57
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.