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 $1.02 Median $1.02 Typical High $1.20 | Facility | None | $1.02 | $1.02 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.20 Typical High $1.66 | Professional | None | $1.02 | $1.20 | $1.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.26 Median $3.39 Typical High $7.08 | Facility | None | $1.26 | $3.39 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $2.95 Typical High $40.74 | Professional | None | $1.58 | $2.95 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.62 Median $1.62 Typical High $3.09 | Professional | RR · Rental | $1.62 | $1.62 | $3.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.23 Median $1.23 Typical High $2.29 | Professional | UE · Used equipment | $1.23 | $1.23 | $2.29 |
Blue Shield Setting Facility Modifier None Typical Low $2.69 Median $4.37 Typical High $6.17 | Facility | None | $2.69 | $4.37 | $6.17 |
Blue Shield Setting Professional Modifier None Typical Low $1.66 Median $2.40 Typical High $4.68 | Professional | None | $1.66 | $2.40 | $4.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.86 Median $2.24 Typical High $3.39 | Professional | None | $1.86 | $2.24 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.70 | Professional | None | $1.17 | $1.17 | $1.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.09 Median $2.29 Typical High $2.29 | Professional | None | $2.09 | $2.29 | $2.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.00 Median $2.88 Typical High $7.76 | Professional | None | $2.00 | $2.88 | $7.76 |
Molina Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Providence Setting Facility Modifier None Typical Low $1.20 Median $1.86 Typical High $4.68 | Facility | None | $1.20 | $1.86 | $4.68 |
Providence Setting Professional Modifier None Typical Low $1.17 Median $2.09 Typical High $2.09 | Professional | None | $1.17 | $2.09 | $2.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
United Setting Professional Modifier None Typical Low $1.45 Median $2.69 Typical High $7.41 | Professional | None | $1.45 | $2.69 | $7.41 |
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 $0.15 Median $0.18 Typical High $0.25 | Professional | 55 · Aftercare only | $0.15 | $0.18 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.12 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.10 | $0.12 | $0.17 |
Where California sits
The same service costs 33.1 times more in Kansas 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· 9th of 51
$2.40
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.