How much rates vary
Facilitymedian $8 · 10th to 90th $4 to $15Professionalmedian $8 · 10th to 90th $4 to $95
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 $3.39 Median $3.72 Typical High $3.89 | Facility | None | $3.39 | $3.72 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.72 Typical High $5.50 | Professional | None | $3.39 | $3.72 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.55 | Professional | None | $9.12 | $9.12 | $9.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.68 Median $5.89 Typical High $24.55 | Facility | None | $4.68 | $5.89 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.46 Median $8.91 Typical High $18.20 | Professional | None | $6.46 | $8.91 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.31 Median $6.31 Typical High $6.76 | Professional | RR · Rental | $6.31 | $6.31 | $6.76 |
Blue Shield Setting Facility Modifier None Typical Low $13.18 Median $17.78 Typical High $26.92 | Facility | None | $13.18 | $17.78 | $26.92 |
Blue Shield Setting Professional Modifier None Typical Low $14.13 Median $26.30 Typical High $47.86 | Professional | None | $14.13 | $26.30 | $47.86 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $10.23 Median $14.79 Typical High $15.14 | Professional | None | $10.23 | $14.79 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $8.13 | Facility | None | $7.59 | $7.59 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.23 Median $14.13 Typical High $15.49 | Professional | None | $10.23 | $14.13 | $15.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $10.23 Typical High $29.51 | Professional | None | $7.76 | $10.23 | $29.51 |
Lucent Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $95.50 | Professional | None | $64.57 | $64.57 | $95.50 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
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 $3.55 Median $7.59 Typical High $12.88 | Facility | None | $3.55 | $7.59 | $12.88 |
Providence Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.89 Typical High $16.22 | Professional | None | $5.01 | $5.89 | $16.22 |
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 $0.51 Median $0.56 Typical High $0.85 | Professional | 55 · Aftercare only | $0.51 | $0.56 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.37 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.34 | $0.37 | $0.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $4.79 Typical High $6.76 | Professional | UE · Used equipment | $4.79 | $4.79 | $6.76 |
Where California sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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· 34th of 51
$7.59
ID $13.49NJ $6.46
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.