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 $1.23 Median $1.35 Typical High $1.41 | Facility | None | $1.23 | $1.35 | $1.41 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.35 Typical High $1.62 | Professional | None | $1.23 | $1.35 | $1.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.70 Median $2.14 Typical High $8.91 | Facility | None | $1.70 | $2.14 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $2.51 Typical High $6.17 | Professional | None | $2.40 | $2.51 | $6.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.29 Median $2.29 Typical High $2.45 | Professional | RR · Rental | $2.29 | $2.29 | $2.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | UE · Used equipment | $1.74 | $1.74 | $1.74 |
Blue Shield Setting Facility Modifier None Typical Low $4.90 Median $6.46 Typical High $9.77 | Facility | None | $4.90 | $6.46 | $9.77 |
Blue Shield Setting Professional Modifier None Typical Low $5.25 Median $9.77 Typical High $17.38 | Professional | None | $5.25 | $9.77 | $17.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.19 | Professional | None | $1.91 | $2.19 | $2.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.80 Median $5.25 Typical High $5.62 | Professional | None | $3.80 | $5.25 | $5.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.82 Median $3.98 Typical High $10.96 | Professional | None | $2.82 | $3.98 | $10.96 |
Lucent Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $35.48 | Professional | None | $22.91 | $22.91 | $35.48 |
Molina Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
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 $1.32 Median $2.57 Typical High $4.68 | Facility | None | $1.32 | $2.57 | $4.68 |
Providence Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.57 | Professional | None | $1.91 | $2.19 | $2.57 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
United Setting Professional Modifier None Typical Low $1.82 Median $2.19 Typical High $5.89 | Professional | None | $1.82 | $2.19 | $5.89 |
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 $0.19 Median $0.20 Typical High $0.31 | Professional | 55 · Aftercare only | $0.19 | $0.20 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.14 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.12 | $0.14 | $0.20 |
Where California sits
The same service costs 2.5 times more in Hawaii than in Vermont. 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· 47th of 51
$2.19
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.