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 $0.31 Median $0.31 Typical High $0.31 | Facility | None | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier None Typical Low $0.30 Median $0.31 Typical High $0.31 | Professional | None | $0.30 | $0.31 | $0.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.26 Median $0.33 Typical High $1.35 | Facility | None | $0.26 | $0.33 | $1.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.10 Median $0.34 Typical High $0.98 | Professional | None | $0.10 | $0.34 | $0.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | UE · Used equipment | $0.26 | $0.26 | $0.26 |
Blue Shield Setting Professional Modifier None Typical Low $0.91 Median $1.38 Typical High $2.19 | Professional | None | $0.91 | $1.38 | $2.19 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $630.96 | Professional | None | $1.00 | $1.00 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $5.50 Median $5.89 Typical High $5.89 | Professional | None | $5.50 | $5.89 | $5.89 |
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 $0.31 Median $0.44 Typical High $1.55 | Facility | None | $0.31 | $0.44 | $1.55 |
Providence Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
United Setting Professional Modifier None Typical Low $0.43 Median $0.44 Typical High $1.00 | Professional | None | $0.43 | $0.44 | $1.00 |
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 $0.05 Median $0.05 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.63 Typical High $0.83 | Professional | RR · Rental | $0.42 | $0.63 | $0.83 |
Where California sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 8th of 51
$1.00
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.