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 $0.54 Median $0.59 Typical High $0.62 | Facility | None | $0.54 | $0.59 | $0.62 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.59 Typical High $0.95 | Professional | None | $0.54 | $0.59 | $0.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.63 Median $0.79 Typical High $3.31 | Facility | None | $0.63 | $0.79 | $3.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.72 Median $2.24 Typical High $7.24 | Professional | None | $0.72 | $2.24 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | UE · Used equipment | $0.65 | $0.65 | $0.65 |
Blue Shield Setting Facility Modifier None Typical Low $2.09 Median $2.82 Typical High $4.27 | Facility | None | $2.09 | $2.82 | $4.27 |
Blue Shield Setting Professional Modifier None Typical Low $2.29 Median $3.72 Typical High $7.41 | Professional | None | $2.29 | $3.72 | $7.41 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $1.62 | Professional | None | $0.25 | $0.25 | $1.62 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $2.75 | Professional | None | $2.04 | $2.24 | $2.75 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.82 Median $2.34 Typical High $120.23 | Professional | None | $1.82 | $2.34 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $12.88 | Professional | None | $10.00 | $10.00 | $12.88 |
Molina Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $2.45 | Professional | None | $0.30 | $0.30 | $2.45 |
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 $0.62 Median $1.86 Typical High $2.04 | Facility | None | $0.62 | $1.86 | $2.04 |
Providence Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.89 Typical High $2.51 | Professional | None | $0.79 | $0.89 | $2.51 |
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 $0.08 Median $0.09 Typical High $0.15 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | RR · Rental | $0.85 | $0.85 | $0.85 |
Where California sits
The same service costs 3.1 times more in Hawaii 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· 30th of 51
$1.02
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.