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 $5.25 Median $5.25 Typical High $5.25 | Facility | None | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.92 | Professional | None | $5.25 | $5.25 | $6.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $363.08 Typical High $489.78 | Professional | None | $8.71 | $363.08 | $489.78 |
Blue Shield Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
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 $91.20 Median $95.50 Typical High $95.50 | Professional | None | $91.20 | $95.50 | $95.50 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
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 $5.25 Median $7.41 Typical High $26.92 | Facility | None | $5.25 | $7.41 | $26.92 |
Providence Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $6.61 Median $7.08 Typical High $16.60 | Professional | None | $6.61 | $7.08 | $16.60 |
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 $0.78 Median $0.78 Typical High $1.02 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.70 Median $26.92 Typical High $57.54 | Professional | RR · Rental | $25.70 | $26.92 | $57.54 |
Where California sits
The same service costs 95.5 times more in New York than in Kentucky. 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· 21st of 51
$9.77
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.