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 $5.13 Median $5.62 Typical High $5.89 | Facility | None | $5.13 | $5.62 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.62 Typical High $8.71 | Professional | None | $5.13 | $5.62 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $9.12 Typical High $37.15 | Facility | None | $7.08 | $9.12 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $28.18 | Professional | None | $10.00 | $13.49 | $28.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.77 Median $9.77 Typical High $10.23 | Professional | RR · Rental | $9.77 | $9.77 | $10.23 |
Blue Shield Setting Facility Modifier None Typical Low $20.42 Median $26.92 Typical High $40.74 | Facility | None | $20.42 | $26.92 | $40.74 |
Blue Shield Setting Professional Modifier None Typical Low $21.88 Median $40.74 Typical High $72.44 | Professional | None | $21.88 | $40.74 | $72.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $18.20 | Professional | None | $15.85 | $17.78 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $12.88 | Facility | None | $11.48 | $11.48 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $11.48 | Professional | None | $9.77 | $9.77 | $11.48 |
Contra Costa Health Setting Professional Modifier None Typical Low $15.85 Median $21.88 Typical High $23.44 | Professional | None | $15.85 | $21.88 | $23.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $45.71 | Professional | None | $11.75 | $15.85 | $45.71 |
Lucent Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $147.91 | Professional | None | $97.72 | $97.72 | $147.91 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
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 $5.50 Median $11.48 Typical High $19.50 | Facility | None | $5.50 | $11.48 | $19.50 |
Providence Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $11.48 | Professional | None | $9.77 | $9.77 | $11.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $7.59 Median $9.12 Typical High $24.55 | Professional | None | $7.59 | $9.12 | $24.55 |
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 $0.78 Median $0.85 Typical High $1.32 | Professional | 55 · Aftercare only | $0.78 | $0.85 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.56 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.52 | $0.56 | $0.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.24 Median $7.24 Typical High $10.23 | Professional | UE · Used equipment | $7.24 | $7.24 | $10.23 |
Where California sits
The same service costs 2.5 times more in Kansas than in Rhode Island. 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· 34th of 51
$11.48
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.