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 $4.27 Median $4.68 Typical High $4.79 | Facility | None | $4.27 | $4.68 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $7.08 | Professional | None | $4.27 | $4.68 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.75 Median $7.41 Typical High $30.20 | Facility | None | $5.75 | $7.41 | $30.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $11.22 Typical High $22.91 | Professional | None | $8.13 | $11.22 | $22.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.94 Median $7.94 Typical High $8.13 | Professional | RR · Rental | $7.94 | $7.94 | $8.13 |
Blue Shield Setting Facility Modifier None Typical Low $16.60 Median $21.88 Typical High $33.11 | Facility | None | $16.60 | $21.88 | $33.11 |
Blue Shield Setting Professional Modifier None Typical Low $17.78 Median $33.11 Typical High $58.88 | Professional | None | $17.78 | $33.11 | $58.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $14.45 | Professional | None | $12.88 | $13.18 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $9.55 Typical High $9.55 | Facility | None | $8.13 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | None | $8.13 | $8.13 | $9.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.88 Median $17.78 Typical High $19.50 | Professional | None | $12.88 | $17.78 | $19.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.55 Median $12.88 Typical High $37.15 | Professional | None | $9.55 | $12.88 | $37.15 |
Lucent Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $120.23 | Professional | None | $79.43 | $79.43 | $120.23 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | None | $22.91 | $22.91 | $33.11 |
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 $4.47 Median $9.55 Typical High $16.22 | Facility | None | $4.47 | $9.55 | $16.22 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | None | $8.13 | $8.13 | $9.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $6.31 Median $7.41 Typical High $19.95 | Professional | None | $6.31 | $7.41 | $19.95 |
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 $0.63 Median $0.71 Typical High $1.07 | Professional | 55 · Aftercare only | $0.63 | $0.71 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.46 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.42 | $0.46 | $0.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.89 Median $5.89 Typical High $8.51 | Professional | UE · Used equipment | $5.89 | $5.89 | $8.51 |
Where California sits
The same service costs 2.2 times more in Kansas 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· 34th 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.