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 $1.74 Median $1.91 Typical High $1.95 | Facility | None | $1.74 | $1.91 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.91 Typical High $2.88 | Professional | None | $1.74 | $1.91 | $2.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.34 Median $3.02 Typical High $12.59 | Facility | None | $2.34 | $3.02 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $4.57 Typical High $9.33 | Professional | None | $3.24 | $4.57 | $9.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | RR · Rental | $3.24 | $3.24 | $3.24 |
Blue Shield Setting Facility Modifier None Typical Low $6.76 Median $9.12 Typical High $13.49 | Facility | None | $6.76 | $9.12 | $13.49 |
Blue Shield Setting Professional Modifier None Typical Low $7.24 Median $13.49 Typical High $24.55 | Professional | None | $7.24 | $13.49 | $24.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.07 | Facility | None | $3.89 | $3.89 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | None | $3.31 | $3.31 | $3.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.25 Median $7.24 Typical High $7.94 | Professional | None | $5.25 | $7.24 | $7.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.98 Median $5.01 Typical High $15.14 | Professional | None | $3.98 | $5.01 | $15.14 |
Lucent Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $48.98 | Professional | None | $33.11 | $33.11 | $48.98 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
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 $1.82 Median $3.89 Typical High $6.61 | Facility | None | $1.82 | $3.89 | $6.61 |
Providence Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | None | $3.31 | $3.31 | $3.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
United Setting Professional Modifier None Typical Low $2.51 Median $3.02 Typical High $8.32 | Professional | None | $2.51 | $3.02 | $8.32 |
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 $0.26 Median $0.28 Typical High $0.44 | Professional | 55 · Aftercare only | $0.26 | $0.28 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.19 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.17 | $0.19 | $0.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $2.40 Typical High $3.47 | Professional | UE · Used equipment | $2.40 | $2.40 | $3.47 |
Where California sits
The same service costs 2.6 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· 31st of 51
$3.89
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.