How much rates vary
Facilitymedian $7 · 10th to 90th $4 to $14Professionalmedian $7 · 10th to 90th $4 to $93
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 $3.31 Median $3.63 Typical High $3.72 | Facility | None | $3.31 | $3.63 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $5.37 | Professional | None | $3.31 | $3.63 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.47 Median $5.75 Typical High $23.44 | Facility | None | $4.47 | $5.75 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.46 Median $8.71 Typical High $16.22 | Professional | None | $6.46 | $8.71 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | RR · Rental | $6.17 | $6.17 | $6.46 |
Blue Shield Setting Facility Modifier None Typical Low $12.88 Median $16.98 Typical High $25.70 | Facility | None | $12.88 | $16.98 | $25.70 |
Blue Shield Setting Professional Modifier None Typical Low $13.80 Median $25.70 Typical High $45.71 | Professional | None | $13.80 | $25.70 | $45.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $10.00 Median $14.45 Typical High $14.45 | Professional | None | $10.00 | $14.45 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.94 | Facility | None | $7.41 | $7.41 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $15.14 | Professional | None | $10.00 | $13.80 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.41 Median $10.72 Typical High $28.84 | Professional | None | $7.41 | $10.72 | $28.84 |
Lucent Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $93.33 | Professional | None | $61.66 | $61.66 | $93.33 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
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 $3.47 Median $7.41 Typical High $12.59 | Facility | None | $3.47 | $7.41 | $12.59 |
Providence Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
Sutter Health Plus Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
United Setting Professional Modifier None Typical Low $4.79 Median $5.75 Typical High $15.49 | Professional | None | $4.79 | $5.75 | $15.49 |
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 $0.49 Median $0.54 Typical High $0.83 | Professional | 55 · Aftercare only | $0.49 | $0.54 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.36 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.33 | $0.36 | $0.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.57 Median $4.57 Typical High $6.61 | Professional | UE · Used equipment | $4.57 | $4.57 | $6.61 |
Where California sits
The same service costs 2.0 times more in Montana than in Florida. 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· 32nd of 51
$7.41
MT $12.88FL $6.31
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.