How much rates vary
Facilitymedian $22 · 10th to 90th $11 to $42Professionalmedian $22 · 10th to 90th $11 to $282
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 $9.77 Median $10.72 Typical High $11.22 | Facility | None | $9.77 | $10.72 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $10.72 Typical High $16.22 | Professional | None | $9.77 | $10.72 | $16.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.02 Median $15.49 Typical High $64.57 | Facility | None | $12.02 | $15.49 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $53.70 | Professional | None | $16.60 | $25.12 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | RR · Rental | $16.60 | $16.60 | $16.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | UE · Used equipment | $12.59 | $12.59 | $12.59 |
Blue Shield Setting Facility Modifier None Typical Low $38.90 Median $51.29 Typical High $77.62 | Facility | None | $38.90 | $51.29 | $77.62 |
Blue Shield Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $138.04 | Professional | None | $41.69 | $77.62 | $138.04 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $33.88 | Professional | None | $30.20 | $30.90 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $21.88 Typical High $21.88 | Facility | None | $18.62 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $44.67 | Professional | None | $30.20 | $41.69 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $26.30 Typical High $87.10 | Professional | None | $22.39 | $26.30 | $87.10 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | None | $199.53 | $199.53 | $281.84 |
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 $10.00 Median $21.88 Typical High $38.02 | Facility | None | $10.00 | $21.88 | $38.02 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $14.79 Median $17.78 Typical High $46.77 | Professional | None | $14.79 | $17.78 | $46.77 |
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 $1.48 Median $1.62 Typical High $2.40 | Professional | 55 · Aftercare only | $1.48 | $1.62 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.07 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.00 | $1.07 | $1.58 |
Where California sits
The same service costs 2.9 times more in Hawaii 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· 29th of 51
$21.88
HI $47.86RI $16.60
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.