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 $0.51 Median $0.51 Typical High $0.59 | Facility | None | $0.51 | $0.51 | $0.59 |
Aetna Setting Professional Modifier None Typical Low $0.51 Median $0.59 Typical High $0.71 | Professional | None | $0.51 | $0.59 | $0.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.52 Median $1.35 Typical High $2.88 | Facility | None | $0.52 | $1.35 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.60 Median $1.15 Typical High $16.22 | Professional | None | $0.60 | $1.15 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.51 Median $0.51 Typical High $0.85 | Professional | UE · Used equipment | $0.51 | $0.51 | $0.85 |
Blue Shield Setting Facility Modifier None Typical Low $1.15 Median $1.91 Typical High $3.09 | Facility | None | $1.15 | $1.91 | $3.09 |
Blue Shield Setting Professional Modifier None Typical Low $0.83 Median $1.17 Typical High $2.04 | Professional | None | $0.83 | $1.17 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.83 Median $0.91 Typical High $0.91 | Professional | None | $0.83 | $0.91 | $0.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.29 Typical High $3.55 | Professional | None | $1.00 | $1.29 | $3.55 |
Lucent Health Setting Professional Modifier None Typical Low $0.91 Median $1.12 Typical High $3.89 | Professional | None | $0.91 | $1.12 | $3.89 |
Molina Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
Providence Setting Facility Modifier None Typical Low $0.59 Median $0.83 Typical High $2.51 | Facility | None | $0.59 | $0.83 | $2.51 |
Providence Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $1.82 | Professional | None | $0.83 | $0.83 | $1.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
United Setting Professional Modifier None Typical Low $0.62 Median $1.29 Typical High $3.16 | Professional | None | $0.62 | $1.29 | $3.16 |
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 $0.08 Median $0.09 Typical High $0.11 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.98 Median $1.26 Typical High $3.47 | Professional | RR · Rental | $0.98 | $1.26 | $3.47 |
Where California sits
The same service costs 3.2 times more in Texas 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· 15th of 51
$1.17
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.