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 $0.72 Median $0.72 Typical High $35.48 | Facility | None | $0.72 | $0.72 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $35.48 | Professional | None | $0.72 | $0.72 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.86 Median $2.14 Typical High $2.57 | Facility | None | $1.86 | $2.14 | $2.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $2.51 Typical High $3.39 | Professional | None | $2.00 | $2.51 | $3.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $4.79 | Professional | RR · Rental | $2.51 | $2.51 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $1.86 Typical High $3.55 | Professional | UE · Used equipment | $1.86 | $1.86 | $3.55 |
Blue Shield Setting Professional Modifier None Typical Low $2.69 Median $3.80 Typical High $5.75 | Professional | None | $2.69 | $3.80 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $8.91 Typical High $23.99 | Professional | None | $5.01 | $8.91 | $23.99 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Providence Setting Facility Modifier None Typical Low $0.72 Median $1.02 Typical High $4.90 | Facility | None | $0.72 | $1.02 | $4.90 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
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 $0.11 Median $0.11 Typical High $5.25 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $3.55 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $3.55 |
Where California sits
The same service costs 158.5 times more in Montana than in Rhode Island. 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· 27th of 51
$3.80
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.