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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $2.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $25.12 Typical High $30.90 | Professional | None | $15.85 | $25.12 | $30.90 |
Blue Shield Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $354.81 | Professional | None | $147.91 | $223.87 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
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 $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $17.78 Median $25.12 Typical High $25.12 | Facility | None | $17.78 | $25.12 | $25.12 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $79.43 Typical High $79.43 | Professional | None | $15.14 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $61.66 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $61.66 |
Where California sits
The same service costs 57.5 times more in Nebraska than in Pennsylvania. 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· 48th of 51
$17.78
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.