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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.22 | Professional | None | $0.15 | $0.15 | $0.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.19 Median $0.25 Typical High $1.02 | Facility | None | $0.19 | $0.25 | $1.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.26 Median $0.32 Typical High $0.81 | Professional | None | $0.26 | $0.32 | $0.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | UE · Used equipment | $0.20 | $0.20 | $0.20 |
Blue Shield Setting Professional Modifier None Typical Low $0.52 Median $0.76 Typical High $1.15 | Professional | None | $0.52 | $0.76 | $1.15 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $831.76 | Professional | None | $104.71 | $134.90 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $7.94 Median $10.23 Typical High $10.23 | Professional | None | $7.94 | $10.23 | $10.23 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $0.15 Median $0.44 Typical High $0.78 | Facility | None | $0.15 | $0.44 | $0.78 |
Providence Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
United Setting Professional Modifier None Typical Low $0.20 Median $0.22 Typical High $0.51 | Professional | None | $0.20 | $0.22 | $0.51 |
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 $0.02 Median $0.02 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.47 Typical High $0.65 | Professional | RR · Rental | $0.32 | $0.47 | $0.65 |
Where California sits
The same service costs 15.5 times more in Minnesota than in Hawaii. 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
$0.28
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.