How much rates vary
Facilitymedian $7 · 10th to 90th $4 to $13Professionalmedian $7 · 10th to 90th $4 to $87
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 $3.09 Median $3.39 Typical High $3.47 | Facility | None | $3.09 | $3.39 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.39 Typical High $5.13 | Professional | None | $3.09 | $3.39 | $5.13 |
Ambetter Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.17 Median $5.37 Typical High $21.88 | Facility | None | $4.17 | $5.37 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $8.13 Typical High $16.22 | Professional | None | $5.89 | $8.13 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | RR · Rental | $5.75 | $5.75 | $6.03 |
Blue Shield Setting Facility Modifier None Typical Low $12.02 Median $15.85 Typical High $23.99 | Facility | None | $12.02 | $15.85 | $23.99 |
Blue Shield Setting Professional Modifier None Typical Low $12.88 Median $23.99 Typical High $42.66 | Professional | None | $12.88 | $23.99 | $42.66 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | None | $9.33 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.59 | Facility | None | $6.92 | $6.92 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | None | $5.89 | $5.89 | $6.92 |
Contra Costa Health Setting Professional Modifier None Typical Low $9.33 Median $12.88 Typical High $14.13 | Professional | None | $9.33 | $12.88 | $14.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.92 Median $10.00 Typical High $29.51 | Professional | None | $6.92 | $10.00 | $29.51 |
Lucent Health Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $87.10 | Professional | None | $57.54 | $57.54 | $87.10 |
Molina Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
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 $3.24 Median $6.92 Typical High $11.75 | Facility | None | $3.24 | $6.92 | $11.75 |
Providence Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | None | $5.89 | $5.89 | $6.92 |
Sutter Health Plus Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $4.47 Median $5.37 Typical High $14.45 | Professional | None | $4.47 | $5.37 | $14.45 |
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 $0.46 Median $0.50 Typical High $0.78 | Professional | 55 · Aftercare only | $0.46 | $0.50 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.34 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.31 | $0.34 | $0.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.27 Median $4.27 Typical High $6.17 | Professional | UE · Used equipment | $4.27 | $4.27 | $6.17 |
Where California sits
The same service costs 2.1 times more in Idaho than in Colorado. 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
$6.92
ID $12.30CO $5.89
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.