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 $0.63 Median $0.69 Typical High $0.72 | Facility | None | $0.63 | $0.69 | $0.72 |
Aetna Setting Professional Modifier None Typical Low $0.63 Median $0.69 Typical High $1.02 | Professional | None | $0.63 | $0.69 | $1.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.87 Median $1.12 Typical High $4.57 | Facility | None | $0.87 | $1.12 | $4.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.58 Typical High $3.39 | Professional | None | $1.17 | $1.58 | $3.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.17 Median $1.17 Typical High $1.26 | Professional | RR · Rental | $1.17 | $1.17 | $1.26 |
Blue Shield Setting Facility Modifier None Typical Low $2.45 Median $3.31 Typical High $5.01 | Facility | None | $2.45 | $3.31 | $5.01 |
Blue Shield Setting Professional Modifier None Typical Low $2.63 Median $4.90 Typical High $8.91 | Professional | None | $2.63 | $4.90 | $8.91 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.91 Median $2.14 Typical High $2.19 | Professional | None | $1.91 | $2.14 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.51 | Facility | None | $1.41 | $1.41 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.91 Median $2.63 Typical High $2.88 | Professional | None | $1.91 | $2.63 | $2.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.45 Median $2.00 Typical High $5.50 | Professional | None | $1.45 | $2.00 | $5.50 |
Lucent Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $17.78 | Professional | None | $12.02 | $12.02 | $17.78 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
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 $0.68 Median $1.41 Typical High $2.40 | Facility | None | $0.68 | $1.41 | $2.40 |
Providence Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.12 Typical High $3.02 | Professional | None | $0.93 | $1.12 | $3.02 |
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 $0.09 Median $0.10 Typical High $0.15 | Professional | 55 · Aftercare only | $0.09 | $0.10 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.89 Median $0.89 Typical High $1.20 | Professional | UE · Used equipment | $0.89 | $0.89 | $1.20 |
Where California sits
The same service costs 5.4 times more in Kansas than in Kentucky. 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
$1.41
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.