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 $0.40 Median $0.40 Typical High $0.40 | Facility | None | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.41 | Professional | None | $0.40 | $0.40 | $0.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.79 Median $0.91 Typical High $1.10 | Facility | None | $0.79 | $0.91 | $1.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.07 Median $1.10 Typical High $1.62 | Professional | None | $1.07 | $1.10 | $1.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $1.07 Typical High $6.92 | Professional | RR · Rental | $1.07 | $1.07 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | UE · Used equipment | $0.79 | $0.79 | $0.79 |
Blue Shield Setting Professional Modifier None Typical Low $1.23 Median $1.74 Typical High $2.63 | Professional | None | $1.23 | $1.74 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $3.02 Typical High $15.14 | Professional | None | $1.00 | $3.02 | $15.14 |
Molina Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Providence Setting Facility Modifier None Typical Low $0.40 Median $0.58 Typical High $1.78 | Facility | None | $0.40 | $0.58 | $1.78 |
Providence Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
United Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
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 $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where California sits
The same service costs 199.5 times more in Montana than in Utah. 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· 21st of 51
$1.23
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.