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 $0.28 Median $0.28 Typical High $0.33 | Facility | None | $0.28 | $0.28 | $0.33 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.33 Typical High $0.38 | Professional | None | $0.28 | $0.33 | $0.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.31 Median $0.76 Typical High $1.66 | Facility | None | $0.31 | $0.76 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.45 Median $0.68 Typical High $17.38 | Professional | None | $0.45 | $0.68 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.30 Median $0.30 Typical High $0.49 | Professional | UE · Used equipment | $0.30 | $0.30 | $0.49 |
Blue Shield Setting Facility Modifier None Typical Low $0.65 Median $1.07 Typical High $1.70 | Facility | None | $0.65 | $1.07 | $1.70 |
Blue Shield Setting Professional Modifier None Typical Low $0.28 Median $0.43 Typical High $0.87 | Professional | None | $0.28 | $0.43 | $0.87 |
Cigna Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | None | $0.33 | $0.33 | $0.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.47 Median $0.52 Typical High $0.52 | Professional | None | $0.47 | $0.52 | $0.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.65 Median $0.95 Typical High $2.00 | Professional | None | $0.65 | $0.95 | $2.00 |
Lucent Health Setting Professional Modifier None Typical Low $0.46 Median $0.55 Typical High $1.95 | Professional | None | $0.46 | $0.55 | $1.95 |
Molina Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Providence Setting Facility Modifier None Typical Low $0.33 Median $0.47 Typical High $1.41 | Facility | None | $0.33 | $0.47 | $1.41 |
Providence Setting Professional Modifier None Typical Low $0.33 Median $0.47 Typical High $0.47 | Professional | None | $0.33 | $0.47 | $0.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | None | $1.05 | $1.05 | $1.05 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.72 Typical High $1.78 | Professional | None | $0.36 | $0.72 | $1.78 |
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 $0.04 Median $0.05 Typical High $0.06 | Professional | 55 · Aftercare only | $0.04 | $0.05 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.58 Median $0.76 Typical High $2.19 | Professional | RR · Rental | $0.58 | $0.76 | $2.19 |
Where California sits
The same service costs 3.0 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· 24th of 51
$0.49
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.