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 $0.54 Median $0.59 Typical High $0.62 | Facility | None | $0.54 | $0.59 | $0.62 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.59 Typical High $0.87 | Professional | None | $0.54 | $0.59 | $0.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.72 Median $0.91 Typical High $3.80 | Facility | None | $0.72 | $0.91 | $3.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.02 Median $1.23 Typical High $2.63 | Professional | None | $1.02 | $1.23 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.74 Median $0.74 Typical High $0.74 | Professional | UE · Used equipment | $0.74 | $0.74 | $0.74 |
Blue Shield Setting Facility Modifier None Typical Low $2.00 Median $2.63 Typical High $3.98 | Facility | None | $2.00 | $2.63 | $3.98 |
Blue Shield Setting Professional Modifier None Typical Low $2.09 Median $3.89 Typical High $7.08 | Professional | None | $2.09 | $3.89 | $7.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.51 Median $2.19 Typical High $2.24 | Professional | None | $1.51 | $2.19 | $2.24 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.29 | Facility | None | $1.20 | $1.20 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.20 | Professional | None | $1.02 | $1.02 | $1.20 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.51 Median $2.09 Typical High $2.29 | Professional | None | $1.51 | $2.09 | $2.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.12 Median $1.70 Typical High $4.37 | Professional | None | $1.12 | $1.70 | $4.37 |
Lucent Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $15.14 | Professional | None | $10.00 | $10.00 | $15.14 |
Molina Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
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 $0.58 Median $1.20 Typical High $1.91 | Facility | None | $0.58 | $1.20 | $1.91 |
Providence Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.20 | Professional | None | $1.02 | $1.02 | $1.20 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.91 Typical High $2.34 | Professional | None | $0.79 | $0.91 | $2.34 |
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 $0.08 Median $0.09 Typical High $0.14 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.10 Median $0.14 Typical High $1.05 | Professional | RR · Rental | $0.10 | $0.14 | $1.05 |
Where California sits
The same service costs 2.1 times more in Kansas 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· 32nd of 51
$1.20
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.