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 $0.23 Median $0.23 Typical High $0.27 | Facility | None | $0.23 | $0.23 | $0.27 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.27 Typical High $0.32 | Professional | None | $0.23 | $0.27 | $0.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.27 Median $0.63 Typical High $1.41 | Facility | None | $0.27 | $0.63 | $1.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.37 Median $0.74 Typical High $17.38 | Professional | None | $0.37 | $0.74 | $17.38 |
Blue Shield Setting Facility Modifier None Typical Low $0.55 Median $0.87 Typical High $1.41 | Facility | None | $0.55 | $0.87 | $1.41 |
Blue Shield Setting Professional Modifier None Typical Low $0.39 Median $0.55 Typical High $0.98 | Professional | None | $0.39 | $0.55 | $0.98 |
Cigna Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | None | $0.24 | $0.24 | $0.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.39 Median $0.43 Typical High $0.43 | Professional | None | $0.39 | $0.43 | $0.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.52 Median $0.71 Typical High $1.62 | Professional | None | $0.52 | $0.71 | $1.62 |
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 $0.56 Median $0.56 Typical High $0.56 | Professional | None | $0.56 | $0.56 | $0.56 |
Providence Setting Facility Modifier None Typical Low $0.27 Median $0.39 Typical High $1.15 | Facility | None | $0.27 | $0.39 | $1.15 |
Providence Setting Professional Modifier None Typical Low $0.24 Median $0.39 Typical High $0.39 | Professional | None | $0.24 | $0.39 | $0.39 |
Sutter Health Plus Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.60 Typical High $1.48 | Professional | None | $0.28 | $0.60 | $1.48 |
4 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 $0.03 Median $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.63 Median $0.65 Typical High $1.78 | Professional | RR · Rental | $0.63 | $0.65 | $1.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.26 Median $0.26 Typical High $0.37 | Professional | UE · Used equipment | $0.26 | $0.26 | $0.37 |
Where California sits
The same service costs 3.1 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· 10th of 51
$0.55
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.