How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $10Professionalmedian $4 · 10th to 90th $2 to $62
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 $2.14 Median $2.34 Typical High $2.45 | Facility | None | $2.14 | $2.34 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.34 Typical High $3.47 | Professional | None | $2.14 | $2.34 | $3.47 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $8.13 | Professional | None | $6.17 | $6.17 | $8.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $3.80 Typical High $15.49 | Facility | None | $2.95 | $3.80 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $5.75 Typical High $11.48 | Professional | None | $4.17 | $5.75 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $4.27 | Professional | RR · Rental | $3.98 | $3.98 | $4.27 |
Blue Shield Setting Facility Modifier None Typical Low $8.51 Median $11.22 Typical High $16.98 | Facility | None | $8.51 | $11.22 | $16.98 |
Blue Shield Setting Professional Modifier None Typical Low $8.91 Median $16.98 Typical High $30.20 | Professional | None | $8.91 | $16.98 | $30.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.31 Median $0.34 Typical High $6.46 | Professional | None | $0.31 | $0.34 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.79 | Professional | None | $4.07 | $4.07 | $4.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.46 Median $8.91 Typical High $9.77 | Professional | None | $6.46 | $8.91 | $9.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $7.08 Typical High $18.62 | Professional | None | $4.90 | $7.08 | $18.62 |
Lucent Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $61.66 | Professional | None | $40.74 | $40.74 | $61.66 |
Molina Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
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 $2.29 Median $4.79 Typical High $8.13 | Facility | None | $2.29 | $4.79 | $8.13 |
Providence Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.79 | Professional | None | $4.07 | $4.07 | $4.79 |
Sutter Health Plus Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.80 Typical High $10.23 | Professional | None | $3.16 | $3.80 | $10.23 |
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 $0.32 Median $0.35 Typical High $0.52 | Professional | 55 · Aftercare only | $0.32 | $0.35 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.24 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.22 | $0.24 | $0.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.02 Typical High $4.27 | Professional | UE · Used equipment | $3.02 | $3.02 | $4.27 |
Where California sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 36th of 51
$4.57
KS $9.55UT $4.07
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.