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 $7.94 Typical High $9.33 | Facility | None | $7.59 | $7.94 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.94 Typical High $14.45 | Professional | None | $7.59 | $7.94 | $14.45 |
Ambetter Setting Professional Modifier None Typical Low $8.91 Median $10.96 Typical High $20.89 | Professional | None | $8.91 | $10.96 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.47 Median $13.18 Typical High $54.95 | Facility | None | $10.47 | $13.18 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $10.72 Typical High $14.45 | Professional | None | $8.32 | $10.72 | $14.45 |
Blue Shield Setting Professional Modifier None Typical Low $7.08 Median $10.00 Typical High $11.75 | Professional | None | $7.08 | $10.00 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.47 Median $11.48 Typical High $12.59 | Professional | None | $10.47 | $11.48 | $12.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $16.98 | Professional | None | $8.51 | $9.55 | $16.98 |
Lucent Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $75.86 | Professional | None | $51.29 | $51.29 | $75.86 |
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 $9.12 Median $11.48 Typical High $13.49 | Facility | None | $9.12 | $11.48 | $13.49 |
Providence Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Sutter Health Plus Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $7.08 Median $9.12 Typical High $14.13 | Professional | None | $7.08 | $9.12 | $14.13 |
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 $0.95 Median $1.20 Typical High $1.38 | Professional | 55 · Aftercare only | $0.95 | $1.20 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.79 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.63 | $0.79 | $0.93 |
Where California sits
The same service costs 2.6 times more in Alaska than in Florida. 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· 25th of 51
$10.00
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.