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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $269.15 | Professional | None | $131.83 | $151.36 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $467.74 | Professional | None | $141.25 | $147.91 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $194.98 | Facility | None | $141.25 | $165.96 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $154.88 Typical High $281.84 | Professional | None | $53.70 | $154.88 | $281.84 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $131.83 Typical High $186.21 | Facility | None | $74.13 | $131.83 | $186.21 |
Blue Shield Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $363.08 | Professional | None | $147.91 | $173.78 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $190.55 | Professional | None | $125.89 | $165.96 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $295.12 Typical High $446.68 | Facility | None | $144.54 | $295.12 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $478.63 | Professional | None | $147.91 | $204.17 | $478.63 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Providence Setting Facility Modifier None Typical Low $123.03 Median $199.53 Typical High $389.05 | Facility | None | $123.03 | $199.53 | $389.05 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $144.54 | Professional | None | $79.43 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $354.81 | Professional | None | $141.25 | $154.88 | $354.81 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where California sits
The same service costs 4.1 times more in Colorado than in Alabama. 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· 3rd of 51
$155
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.