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 $6.46 Median $7.08 Typical High $7.41 | Facility | None | $6.46 | $7.08 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $7.08 Typical High $10.72 | Professional | None | $6.46 | $7.08 | $10.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.71 Median $11.22 Typical High $46.77 | Facility | None | $8.71 | $11.22 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $33.88 | Professional | None | $12.02 | $12.88 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | RR · Rental | $12.02 | $12.02 | $12.02 |
Blue Shield Setting Facility Modifier None Typical Low $25.12 Median $33.88 Typical High $51.29 | Facility | None | $25.12 | $33.88 | $51.29 |
Blue Shield Setting Professional Modifier None Typical Low $26.92 Median $50.12 Typical High $91.20 | Professional | None | $26.92 | $50.12 | $91.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $13.49 | Professional | None | $10.00 | $13.49 | $13.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $29.51 | Professional | None | $19.50 | $26.92 | $29.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $56.23 | Professional | None | $15.14 | $19.95 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $181.97 | Professional | None | $123.03 | $123.03 | $181.97 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
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 $6.92 Median $15.85 Typical High $24.55 | Facility | None | $6.92 | $15.85 | $24.55 |
Providence Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $15.85 | Professional | None | $10.00 | $13.49 | $15.85 |
Sutter Health Plus Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
United Setting Professional Modifier None Typical Low $9.55 Median $11.22 Typical High $30.90 | Professional | None | $9.55 | $11.22 | $30.90 |
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 $0.95 Median $1.07 Typical High $1.62 | Professional | 55 · Aftercare only | $0.95 | $1.07 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.71 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.65 | $0.71 | $1.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | UE · Used equipment | $9.12 | $9.12 | $12.88 |
Where California sits
The same service costs 2.3 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· 39th of 51
$13.49
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.