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 $7.59 Median $8.91 Typical High $21.88 | Facility | None | $7.59 | $8.91 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $13.18 Typical High $23.99 | Professional | None | $7.41 | $13.18 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.33 Median $11.75 Typical High $47.86 | Facility | None | $9.33 | $11.75 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $17.38 Typical High $23.44 | Professional | None | $9.33 | $17.38 | $23.44 |
Blue Shield Setting Professional Modifier None Typical Low $7.24 Median $16.60 Typical High $26.30 | Professional | None | $7.24 | $16.60 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Contra Costa Health Setting Professional Modifier None Typical Low $8.71 Median $13.80 Typical High $35.48 | Professional | None | $8.71 | $13.80 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $22.91 Typical High $37.15 | Professional | None | $7.76 | $22.91 | $37.15 |
Lucent Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | None | $147.91 | $147.91 | $208.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $9.33 Median $18.20 Typical High $33.88 | Facility | None | $9.33 | $18.20 | $33.88 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Sutter Health Plus Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $75.86 | Professional | None | $28.84 | $28.84 | $75.86 |
United Setting Professional Modifier None Typical Low $7.08 Median $17.78 Typical High $32.36 | Professional | None | $7.08 | $17.78 | $32.36 |
4 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 Facility Modifier 55 · Aftercare only Typical Low $1.15 Median $1.35 Typical High $3.31 | Facility | 55 · Aftercare only | $1.15 | $1.35 | $3.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.89 Typical High $2.19 | Facility | 56 · Pre-op care only | $0.78 | $0.89 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.78 Typical High $3.31 | Professional | 55 · Aftercare only | $1.12 | $1.78 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $1.20 Typical High $2.19 | Professional | 56 · Pre-op care only | $0.74 | $1.20 | $2.19 |
Where California sits
The same service costs 3.8 times more in Alaska than in Washington, DC. 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· 44th of 51
$17.78
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.