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 $0.68 Median $0.74 Typical High $0.78 | Facility | None | $0.68 | $0.74 | $0.78 |
Aetna Setting Professional Modifier None Typical Low $0.68 Median $0.74 Typical High $1.12 | Professional | None | $0.68 | $0.74 | $1.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.91 Median $1.17 Typical High $4.79 | Facility | None | $0.91 | $1.17 | $4.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.78 Typical High $3.55 | Professional | None | $1.32 | $1.78 | $3.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.26 Median $1.26 Typical High $1.32 | Professional | RR · Rental | $1.26 | $1.26 | $1.32 |
Blue Shield Setting Facility Modifier None Typical Low $2.63 Median $3.55 Typical High $5.37 | Facility | None | $2.63 | $3.55 | $5.37 |
Blue Shield Setting Professional Modifier None Typical Low $2.82 Median $5.25 Typical High $9.33 | Professional | None | $2.82 | $5.25 | $9.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.04 Median $2.95 Typical High $3.02 | Professional | None | $2.04 | $2.95 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.58 | Facility | None | $1.51 | $1.51 | $1.58 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | None | $1.29 | $1.29 | $1.51 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.04 Median $2.82 Typical High $3.09 | Professional | None | $2.04 | $2.82 | $3.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.55 Median $2.19 Typical High $5.89 | Professional | None | $1.55 | $2.19 | $5.89 |
Lucent Health Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $19.05 | Professional | None | $12.88 | $12.88 | $19.05 |
Molina Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
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 $0.71 Median $1.51 Typical High $2.57 | Facility | None | $0.71 | $1.51 | $2.57 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | None | $1.29 | $1.29 | $1.51 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.17 Typical High $3.24 | Professional | None | $1.00 | $1.17 | $3.24 |
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 $0.10 Median $0.11 Typical High $0.17 | Professional | 55 · Aftercare only | $0.10 | $0.11 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.93 Median $0.93 Typical High $1.35 | Professional | UE · Used equipment | $0.93 | $0.93 | $1.35 |
Where California sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 31st of 51
$1.51
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.