How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.00 Median $5.25 Typical High $6.61 | Professional | None | $1.00 | $5.25 | $6.61 |
Blue Shield Setting Professional Modifier None Typical Low $2.45 Median $3.72 Typical High $6.03 | Professional | None | $2.45 | $3.72 | $6.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Molina Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
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 $7.94 Median $11.48 Typical High $11.48 | Facility | None | $7.94 | $11.48 | $11.48 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $89.13 | Professional | None | $60.26 | $79.43 | $89.13 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.46 Median $0.56 Typical High $0.63 | Professional | RR · Rental | $0.46 | $0.56 | $0.63 |
Where California sits
The same service costs 79.4 times more in Montana than in Indiana. 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· 17th of 51
$7.94
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.