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 $1.78 Median $1.95 Typical High $2.04 | Facility | None | $1.78 | $1.95 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $1.95 Typical High $2.88 | Professional | None | $1.78 | $1.95 | $2.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.04 Median $2.63 Typical High $10.72 | Facility | None | $2.04 | $2.63 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $4.37 Typical High $8.32 | Professional | None | $2.82 | $4.37 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | RR · Rental | $2.82 | $2.82 | $2.82 |
Blue Shield Setting Facility Modifier None Typical Low $5.89 Median $7.76 Typical High $11.75 | Facility | None | $5.89 | $7.76 | $11.75 |
Blue Shield Setting Professional Modifier None Typical Low $6.31 Median $11.75 Typical High $20.89 | Professional | None | $6.31 | $11.75 | $20.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.57 Median $4.68 Typical High $5.13 | Professional | None | $4.57 | $4.68 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.57 Median $6.31 Typical High $6.92 | Professional | None | $4.57 | $6.31 | $6.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.63 Median $5.13 Typical High $13.18 | Professional | None | $3.63 | $5.13 | $13.18 |
Lucent Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $50.12 | Professional | None | $32.36 | $32.36 | $50.12 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
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 $1.91 Median $3.98 Typical High $5.75 | Facility | None | $1.91 | $3.98 | $5.75 |
Providence Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Sutter Health Plus Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.95 Typical High $7.08 | Professional | None | $2.57 | $2.95 | $7.08 |
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 $0.26 Median $0.28 Typical High $0.43 | Professional | 55 · Aftercare only | $0.26 | $0.28 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.19 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.18 | $0.19 | $0.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.09 Median $2.09 Typical High $3.31 | Professional | UE · Used equipment | $2.09 | $2.09 | $3.31 |
Where California sits
The same service costs 2.2 times more in Minnesota 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· 31st of 51
$3.98
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.