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 $1.35 Median $1.48 Typical High $1.55 | Facility | None | $1.35 | $1.48 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $2.19 | Professional | None | $1.35 | $1.48 | $2.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.40 Median $3.02 Typical High $12.59 | Facility | None | $2.40 | $3.02 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $7.24 | Professional | None | $3.24 | $3.55 | $7.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.36 Median $3.24 Typical High $3.24 | Professional | RR · Rental | $0.36 | $3.24 | $3.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | UE · Used equipment | $2.45 | $2.45 | $2.45 |
Blue Shield Setting Facility Modifier None Typical Low $5.25 Median $7.08 Typical High $10.47 | Facility | None | $5.25 | $7.08 | $10.47 |
Blue Shield Setting Professional Modifier None Typical Low $5.62 Median $10.47 Typical High $18.62 | Professional | None | $5.62 | $10.47 | $18.62 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.12 Median $8.13 Typical High $74.13 | Professional | None | $1.12 | $8.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.72 | Facility | None | $3.02 | $3.02 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.07 Median $5.62 Typical High $6.17 | Professional | None | $4.07 | $5.62 | $6.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.09 Median $4.57 Typical High $13.49 | Professional | None | $3.09 | $4.57 | $13.49 |
Lucent Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $38.02 | Professional | None | $25.12 | $25.12 | $38.02 |
Molina Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $33.11 | Professional | None | $5.01 | $5.01 | $33.11 |
Providence Setting Facility Modifier None Typical Low $1.41 Median $3.02 Typical High $5.13 | Facility | None | $1.41 | $3.02 | $5.13 |
Providence Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $2.00 Median $2.40 Typical High $6.31 | Professional | None | $2.00 | $2.40 | $6.31 |
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 $0.20 Median $0.22 Typical High $0.33 | Professional | 55 · Aftercare only | $0.20 | $0.22 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.15 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.13 | $0.15 | $0.23 |
Where California sits
The same service costs 2.2 times more in Kansas than in Delaware. 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· 40th of 51
$3.02
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.