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 $3.63 Median $3.63 Typical High $4.17 | Facility | None | $3.63 | $3.63 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $4.17 Typical High $7.76 | Professional | None | $3.63 | $4.17 | $7.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.01 Median $18.62 Typical High $36.31 | Facility | None | $5.01 | $18.62 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $15.85 Typical High $52.48 | Professional | None | $3.55 | $15.85 | $52.48 |
Blue Shield Setting Facility Modifier None Typical Low $10.96 Median $17.38 Typical High $27.54 | Facility | None | $10.96 | $17.38 | $27.54 |
Blue Shield Setting Professional Modifier None Typical Low $5.13 Median $7.24 Typical High $14.79 | Professional | None | $5.13 | $7.24 | $14.79 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $10.96 | Professional | None | $7.41 | $7.41 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.41 Median $12.59 Typical High $12.59 | Professional | None | $7.41 | $12.59 | $12.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.23 Median $14.79 Typical High $31.62 | Professional | None | $10.23 | $14.79 | $31.62 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Providence Setting Facility Modifier None Typical Low $4.17 Median $6.03 Typical High $11.75 | Facility | None | $4.17 | $6.03 | $11.75 |
Providence Setting Professional Modifier None Typical Low $5.13 Median $11.48 Typical High $11.48 | Professional | None | $5.13 | $11.48 | $11.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $6.92 Median $12.02 Typical High $36.31 | Professional | None | $6.92 | $12.02 | $36.31 |
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 $0.54 Median $0.63 Typical High $1.23 | Professional | 55 · Aftercare only | $0.54 | $0.63 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.42 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.36 | $0.42 | $0.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $10.23 Typical High $13.49 | Professional | RR · Rental | $6.61 | $10.23 | $13.49 |
Where California sits
The same service costs 4.7 times more in Florida than in New York. 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· 7th of 51
$11.48
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.