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 $4.47 Median $4.90 Typical High $5.13 | Facility | None | $4.47 | $4.90 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.90 Typical High $7.08 | Professional | None | $4.47 | $4.90 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $6.61 Typical High $27.54 | Facility | None | $5.13 | $6.61 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $11.22 Typical High $20.89 | Professional | None | $7.24 | $11.22 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $7.59 | Professional | RR · Rental | $7.08 | $7.08 | $7.59 |
Blue Shield Setting Facility Modifier None Typical Low $14.79 Median $19.95 Typical High $29.51 | Facility | None | $14.79 | $19.95 | $29.51 |
Blue Shield Setting Professional Modifier None Typical Low $15.85 Median $29.51 Typical High $53.70 | Professional | None | $15.85 | $29.51 | $53.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $11.48 Median $15.85 Typical High $17.38 | Professional | None | $11.48 | $15.85 | $17.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.71 Median $11.48 Typical High $33.11 | Professional | None | $8.71 | $11.48 | $33.11 |
Lucent Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | None | $85.11 | $85.11 | $107.15 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
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 $4.79 Median $10.00 Typical High $14.45 | Facility | None | $4.79 | $10.00 | $14.45 |
Providence Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $6.61 Median $7.41 Typical High $18.20 | Professional | None | $6.61 | $7.41 | $18.20 |
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 $0.68 Median $0.72 Typical High $1.07 | Professional | 55 · Aftercare only | $0.68 | $0.72 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.49 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.45 | $0.49 | $0.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.37 Median $5.37 Typical High $8.51 | Professional | UE · Used equipment | $5.37 | $5.37 | $8.51 |
Where California sits
The same service costs 2.3 times more in Montana 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· 32nd of 51
$9.55
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.