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 $1.58 Median $1.74 Typical High $1.78 | Facility | None | $1.58 | $1.74 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.74 Typical High $2.63 | Professional | None | $1.58 | $1.74 | $2.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.14 Median $2.75 Typical High $11.22 | Facility | None | $2.14 | $2.75 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $3.16 Typical High $8.32 | Professional | None | $2.95 | $3.16 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | RR · Rental | $2.95 | $2.95 | $2.95 |
Blue Shield Setting Facility Modifier None Typical Low $6.17 Median $8.13 Typical High $12.30 | Facility | None | $6.17 | $8.13 | $12.30 |
Blue Shield Setting Professional Modifier None Typical Low $6.61 Median $12.30 Typical High $21.88 | Professional | None | $6.61 | $12.30 | $21.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.79 Median $6.61 Typical High $7.24 | Professional | None | $4.79 | $6.61 | $7.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.63 Median $5.13 Typical High $13.80 | Professional | None | $3.63 | $5.13 | $13.80 |
Lucent Health Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $44.67 | Professional | None | $29.51 | $29.51 | $44.67 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
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 $1.66 Median $3.80 Typical High $6.03 | Facility | None | $1.66 | $3.80 | $6.03 |
Providence Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.80 | Professional | None | $2.45 | $3.24 | $3.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $2.29 Median $2.75 Typical High $7.41 | Professional | None | $2.29 | $2.75 | $7.41 |
3 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 $0.24 Median $0.26 Typical High $0.39 | Professional | 55 · Aftercare only | $0.24 | $0.26 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.19 Median $2.19 Typical High $3.16 | Professional | UE · Used equipment | $2.19 | $2.19 | $3.16 |
Where California sits
The same service costs 3.2 times more in Kansas than in New Hampshire. 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· 43rd of 51
$3.24
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.