How much rates vary
Facilitymedian $3 · 10th to 90th $1 to $5Professionalmedian $3 · 10th to 90th $1 to $33
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 $1.20 Median $1.32 Typical High $1.35 | Facility | None | $1.20 | $1.32 | $1.35 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $1.32 Typical High $1.86 | Professional | None | $1.20 | $1.32 | $1.86 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.55 Median $2.00 Typical High $8.32 | Facility | None | $1.55 | $2.00 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $3.09 Typical High $6.46 | Professional | None | $2.19 | $3.09 | $6.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.14 Median $2.14 Typical High $2.24 | Professional | RR · Rental | $2.14 | $2.14 | $2.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | UE · Used equipment | $1.58 | $1.58 | $1.58 |
Blue Shield Setting Facility Modifier None Typical Low $4.68 Median $6.17 Typical High $9.33 | Facility | None | $4.68 | $6.17 | $9.33 |
Blue Shield Setting Professional Modifier None Typical Low $5.01 Median $9.33 Typical High $16.60 | Professional | None | $5.01 | $9.33 | $16.60 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.63 Median $5.25 Typical High $5.37 | Professional | None | $3.63 | $5.25 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.95 | Facility | None | $2.69 | $2.69 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.63 Median $5.01 Typical High $5.50 | Professional | None | $3.63 | $5.01 | $5.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.69 Median $3.89 Typical High $10.47 | Professional | None | $2.69 | $3.89 | $10.47 |
Lucent Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $33.11 | Professional | None | $22.39 | $22.39 | $33.11 |
Molina Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
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 $1.29 Median $2.69 Typical High $4.57 | Facility | None | $1.29 | $2.69 | $4.57 |
Providence Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.09 Typical High $5.62 | Professional | None | $1.78 | $2.09 | $5.62 |
2 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 $0.18 Median $0.20 Typical High $0.28 | Professional | 55 · Aftercare only | $0.18 | $0.20 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.13 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.12 | $0.13 | $0.19 |
Where California sits
The same service costs 2.3 times more in Hawaii 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· 30th of 51
$2.69
HI $5.13CT $2.24
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.