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 $3.72 Median $3.72 Typical High $4.37 | Facility | None | $3.72 | $3.72 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $4.37 Typical High $8.51 | Professional | None | $3.72 | $4.37 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.25 Median $19.50 Typical High $38.02 | Facility | None | $5.25 | $19.50 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $15.49 Typical High $53.70 | Professional | None | $3.63 | $15.49 | $53.70 |
Blue Shield Setting Facility Modifier None Typical Low $11.22 Median $17.78 Typical High $28.18 | Facility | None | $11.22 | $17.78 | $28.18 |
Blue Shield Setting Professional Modifier None Typical Low $5.25 Median $7.59 Typical High $15.14 | Professional | None | $5.25 | $7.59 | $15.14 |
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 $11.75 Median $12.88 Typical High $12.88 | Professional | None | $11.75 | $12.88 | $12.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.72 Median $15.49 Typical High $33.11 | Professional | None | $10.72 | $15.49 | $33.11 |
Molina Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Providence Setting Facility Modifier None Typical Low $4.37 Median $6.31 Typical High $12.02 | Facility | None | $4.37 | $6.31 | $12.02 |
Providence Setting Professional Modifier None Typical Low $5.13 Median $11.75 Typical High $11.75 | Professional | None | $5.13 | $11.75 | $11.75 |
Sutter Health Plus Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
United Setting Professional Modifier None Typical Low $7.24 Median $12.30 Typical High $37.15 | Professional | None | $7.24 | $12.30 | $37.15 |
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 $0.56 Median $0.65 Typical High $1.26 | Professional | 55 · Aftercare only | $0.56 | $0.65 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.44 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.38 | $0.44 | $0.85 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $10.72 Typical High $14.13 | Professional | RR · Rental | $6.76 | $10.72 | $14.13 |
Where California sits
The same service costs 4.6 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· 5th of 51
$11.75
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.