How much rates vary
Facilitymedian $21 · 10th to 90th $11 to $38Professionalmedian $21 · 10th to 90th $11 to $263
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 $9.55 Median $10.47 Typical High $10.96 | Facility | None | $9.55 | $10.47 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $10.47 Typical High $14.79 | Professional | None | $9.55 | $10.47 | $14.79 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $14.79 Typical High $61.66 | Facility | None | $11.75 | $14.79 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $23.99 Typical High $51.29 | Professional | None | $15.85 | $23.99 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | RR · Rental | $15.85 | $15.85 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | UE · Used equipment | $12.02 | $12.02 | $12.02 |
Blue Shield Setting Facility Modifier None Typical Low $37.15 Median $48.98 Typical High $74.13 | Facility | None | $37.15 | $48.98 | $74.13 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $131.83 | Professional | None | $39.81 | $74.13 | $131.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $32.36 | Professional | None | $28.84 | $29.51 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $21.38 Typical High $21.38 | Facility | None | $17.78 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $28.84 Median $39.81 Typical High $43.65 | Professional | None | $28.84 | $39.81 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $83.18 | Professional | None | $21.38 | $25.70 | $83.18 |
Lucent Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $263.03 | Professional | None | $177.83 | $177.83 | $263.03 |
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 $10.23 Median $21.38 Typical High $36.31 | Facility | None | $10.23 | $21.38 | $36.31 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
United Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $44.67 | Professional | None | $14.13 | $16.60 | $44.67 |
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 $1.41 Median $1.55 Typical High $2.24 | Professional | 55 · Aftercare only | $1.41 | $1.55 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.05 Typical High $1.48 | Professional | 56 · Pre-op care only | $0.95 | $1.05 | $1.48 |
Where California sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 28th of 51
$21.38
HI $41.69NH $15.85
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.