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 $6.76 Median $6.76 Typical High $7.76 | Facility | None | $6.76 | $6.76 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $7.76 Typical High $10.96 | Professional | None | $6.76 | $7.76 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.51 Median $22.91 Typical High $47.86 | Facility | None | $8.51 | $22.91 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $19.95 Typical High $257.04 | Professional | None | $10.47 | $19.95 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.96 Median $10.96 Typical High $20.89 | Professional | RR · Rental | $10.96 | $10.96 | $20.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.13 Median $8.13 Typical High $15.49 | Professional | UE · Used equipment | $8.13 | $8.13 | $15.49 |
Blue Shield Setting Facility Modifier None Typical Low $17.38 Median $28.18 Typical High $40.74 | Facility | None | $17.38 | $28.18 | $40.74 |
Blue Shield Setting Professional Modifier None Typical Low $10.96 Median $15.85 Typical High $30.20 | Professional | None | $10.96 | $15.85 | $30.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $23.99 | Professional | None | $12.88 | $16.22 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Contra Costa Health Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $15.49 | Professional | None | $14.13 | $15.49 | $15.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.85 Median $18.20 Typical High $51.29 | Professional | None | $15.85 | $18.20 | $51.29 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Providence Setting Facility Modifier None Typical Low $7.76 Median $11.22 Typical High $23.99 | Facility | None | $7.76 | $11.22 | $23.99 |
Providence Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.45 | Professional | None | $14.13 | $14.13 | $14.45 |
Sutter Health Plus Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
United Setting Professional Modifier None Typical Low $9.55 Median $17.78 Typical High $50.12 | Professional | None | $9.55 | $17.78 | $50.12 |
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 $1.00 Median $1.17 Typical High $1.66 | Professional | 55 · Aftercare only | $1.00 | $1.17 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.78 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.68 | $0.78 | $1.10 |
Where California sits
The same service costs 3.5 times more in Florida than in Alabama. 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· 11th of 51
$15.85
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.