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 $5.62 Median $6.17 Typical High $6.46 | Facility | None | $5.62 | $6.17 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $6.17 Typical High $9.55 | Professional | None | $5.62 | $6.17 | $9.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.76 Median $9.77 Typical High $40.74 | Facility | None | $7.76 | $9.77 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $14.13 Typical High $30.20 | Professional | None | $10.47 | $14.13 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | RR · Rental | $10.47 | $10.47 | $10.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | UE · Used equipment | $7.94 | $7.94 | $7.94 |
Blue Shield Setting Facility Modifier None Typical Low $21.88 Median $29.51 Typical High $44.67 | Facility | None | $21.88 | $29.51 | $44.67 |
Blue Shield Setting Professional Modifier None Typical Low $23.44 Median $43.65 Typical High $79.43 | Professional | None | $23.44 | $43.65 | $79.43 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $11.75 | Professional | None | $8.71 | $11.75 | $11.75 |
Contra Costa Health Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $25.70 | Professional | None | $16.98 | $23.44 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $16.98 Typical High $48.98 | Professional | None | $12.88 | $16.98 | $48.98 |
Lucent Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $162.18 | Professional | None | $107.15 | $107.15 | $162.18 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
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 $6.03 Median $13.80 Typical High $21.38 | Facility | None | $6.03 | $13.80 | $21.38 |
Providence Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $13.80 | Professional | None | $8.71 | $11.75 | $13.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $8.32 Median $9.77 Typical High $26.92 | Professional | None | $8.32 | $9.77 | $26.92 |
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 $0.83 Median $0.91 Typical High $1.41 | Professional | 55 · Aftercare only | $0.83 | $0.91 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.62 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.56 | $0.62 | $0.95 |
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· 33rd of 51
$11.75
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.