How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $4Professionalmedian $2 · 10th to 90th $1 to $29
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 $1.00 Median $1.12 Typical High $1.15 | Facility | None | $1.00 | $1.12 | $1.15 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.12 Typical High $1.66 | Professional | None | $1.00 | $1.12 | $1.66 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.38 Median $1.78 Typical High $7.24 | Facility | None | $1.38 | $1.78 | $7.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $2.40 Typical High $5.37 | Professional | None | $1.95 | $2.40 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.31 Median $1.91 Typical High $1.91 | Professional | RR · Rental | $0.31 | $1.91 | $1.91 |
Blue Shield Setting Facility Modifier None Typical Low $3.98 Median $5.25 Typical High $7.94 | Facility | None | $3.98 | $5.25 | $7.94 |
Blue Shield Setting Professional Modifier None Typical Low $4.27 Median $7.94 Typical High $14.13 | Professional | None | $4.27 | $7.94 | $14.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.09 Median $4.47 Typical High $4.47 | Professional | None | $3.09 | $4.47 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.40 | Facility | None | $2.29 | $2.29 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.29 | Professional | None | $1.95 | $1.95 | $2.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.09 Median $4.27 Typical High $4.68 | Professional | None | $3.09 | $4.27 | $4.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.29 Median $3.31 Typical High $8.91 | Professional | None | $2.29 | $3.31 | $8.91 |
Lucent Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $28.84 | Professional | None | $19.05 | $19.05 | $28.84 |
Molina Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
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 $1.07 Median $2.29 Typical High $3.89 | Facility | None | $1.07 | $2.29 | $3.89 |
Providence Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.29 | Professional | None | $1.95 | $1.95 | $2.29 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.78 Typical High $4.79 | Professional | None | $1.51 | $1.78 | $4.79 |
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 $0.15 Median $0.17 Typical High $0.26 | Professional | 55 · Aftercare only | $0.15 | $0.17 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.41 Median $1.41 Typical High $2.04 | Professional | UE · Used equipment | $1.41 | $1.41 | $2.04 |
Where California sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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· 33rd of 51
$2.29
ID $4.07NJ $1.95
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.