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 $181.97 Median $181.97 Typical High $251.19 | Facility | None | $181.97 | $181.97 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $354.81 | Professional | None | $169.82 | $199.53 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $630.96 | Professional | None | $190.55 | $190.55 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $263.03 | Facility | None | $190.55 | $223.87 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $213.80 Typical High $380.19 | Professional | None | $85.11 | $213.80 | $380.19 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $181.97 Typical High $257.04 | Facility | None | $75.86 | $181.97 | $257.04 |
Blue Shield Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $489.78 | Professional | None | $199.53 | $234.42 | $489.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $263.03 | Professional | None | $177.83 | $229.09 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $398.11 Typical High $602.56 | Facility | None | $199.53 | $398.11 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $660.69 | Professional | None | $204.17 | $269.15 | $660.69 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $524.81 | Facility | None | $181.97 | $257.04 | $524.81 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $478.63 | Professional | None | $194.98 | $208.93 | $478.63 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Where California sits
The same service costs 562.3 times more in Montana than in Rhode Island. 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· 6th of 51
$214
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.