How much rates vary
Facilitymedian $8 · 10th to 90th $4 to $17Professionalmedian $8 · 10th to 90th $4 to $105
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 $3.72 Median $4.07 Typical High $4.27 | Facility | None | $3.72 | $4.07 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $4.07 Typical High $6.17 | Professional | None | $3.72 | $4.07 | $6.17 |
Ambetter Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.13 | Professional | None | $10.47 | $10.47 | $14.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.01 Median $6.46 Typical High $26.92 | Facility | None | $5.01 | $6.46 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $9.77 Typical High $19.50 | Professional | None | $7.08 | $9.77 | $19.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $7.24 | Professional | RR · Rental | $6.92 | $6.92 | $7.24 |
Blue Shield Setting Facility Modifier None Typical Low $14.45 Median $19.50 Typical High $28.84 | Facility | None | $14.45 | $19.50 | $28.84 |
Blue Shield Setting Professional Modifier None Typical Low $15.49 Median $28.84 Typical High $51.29 | Professional | None | $15.49 | $28.84 | $51.29 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $11.22 Median $16.22 Typical High $16.60 | Professional | None | $11.22 | $16.22 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.91 | Facility | None | $8.32 | $8.32 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | None | $7.08 | $7.08 | $8.32 |
Contra Costa Health Setting Professional Modifier None Typical Low $11.22 Median $15.49 Typical High $16.98 | Professional | None | $11.22 | $15.49 | $16.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.51 Median $12.02 Typical High $32.36 | Professional | None | $8.51 | $12.02 | $32.36 |
Lucent Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $104.71 | Professional | None | $70.79 | $70.79 | $104.71 |
Molina Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
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 $3.89 Median $8.32 Typical High $14.13 | Facility | None | $3.89 | $8.32 | $14.13 |
Providence Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | None | $7.08 | $7.08 | $8.32 |
Sutter Health Plus Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
United Setting Professional Modifier None Typical Low $5.50 Median $6.46 Typical High $17.78 | Professional | None | $5.50 | $6.46 | $17.78 |
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 $0.56 Median $0.62 Typical High $0.93 | Professional | 55 · Aftercare only | $0.56 | $0.62 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.41 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.37 | $0.41 | $0.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.13 Median $5.13 Typical High $7.41 | Professional | UE · Used equipment | $5.13 | $5.13 | $7.41 |
Where California sits
The same service costs 2.1 times more in Idaho than in Delaware. 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
$8.32
ID $14.79DE $7.08
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.