How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $3Professionalmedian $1 · 10th to 90th $1 to $23
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 $0.60 Median $0.66 Typical High $0.69 | Facility | None | $0.60 | $0.66 | $0.69 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.66 Typical High $0.93 | Professional | None | $0.60 | $0.66 | $0.93 |
Ambetter Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.87 Median $1.12 Typical High $4.68 | Facility | None | $0.87 | $1.12 | $4.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.12 Median $1.48 Typical High $3.24 | Professional | None | $1.12 | $1.48 | $3.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.17 Median $1.20 Typical High $1.20 | Professional | RR · Rental | $1.17 | $1.20 | $1.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.83 Median $0.89 Typical High $0.89 | Professional | UE · Used equipment | $0.83 | $0.89 | $0.89 |
Blue Shield Setting Facility Modifier None Typical Low $2.34 Median $3.16 Typical High $4.68 | Facility | None | $2.34 | $3.16 | $4.68 |
Blue Shield Setting Professional Modifier None Typical Low $2.51 Median $4.68 Typical High $8.32 | Professional | None | $2.51 | $4.68 | $8.32 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.03 Median $0.03 Typical High $1.82 | Professional | None | $0.03 | $0.03 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.15 Median $1.35 Typical High $1.35 | Facility | None | $1.15 | $1.35 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.35 | Professional | None | $1.12 | $1.12 | $1.35 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.82 Median $2.51 Typical High $2.69 | Professional | None | $1.82 | $2.51 | $2.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.35 Median $2.00 Typical High $5.25 | Professional | None | $1.35 | $2.00 | $5.25 |
Lucent Health Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Molina Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
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 $0.65 Median $1.35 Typical High $2.29 | Facility | None | $0.65 | $1.35 | $2.29 |
Providence Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.35 | Professional | None | $1.12 | $1.12 | $1.35 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.05 Typical High $2.82 | Professional | None | $0.87 | $1.05 | $2.82 |
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 $0.09 Median $0.10 Typical High $0.14 | Professional | 55 · Aftercare only | $0.09 | $0.10 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.10 |
Where California sits
The same service costs 5.8 times more in Hawaii 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· 44th of 51
$1.12
HI $5.75RI $1.00
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.