How much rates vary
Facilitymedian $27 · 10th to 90th $13 to $45Professionalmedian $25 · 10th to 90th $13 to $398
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 $12.02 Median $12.88 Typical High $13.49 | Facility | None | $12.02 | $12.88 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $19.50 | Professional | None | $12.02 | $12.88 | $19.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $16.22 Typical High $66.07 | Facility | None | $12.59 | $16.22 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $29.51 Typical High $57.54 | Professional | None | $17.38 | $29.51 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | RR · Rental | $17.38 | $17.38 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | UE · Used equipment | $12.88 | $12.88 | $12.88 |
Blue Shield Setting Facility Modifier None Typical Low $41.69 Median $54.95 Typical High $83.18 | Facility | None | $41.69 | $54.95 | $83.18 |
Blue Shield Setting Professional Modifier None Typical Low $43.65 Median $83.18 Typical High $147.91 | Professional | None | $43.65 | $83.18 | $147.91 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $36.31 | Professional | None | $28.18 | $30.90 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $26.92 Typical High $26.92 | Facility | None | $22.91 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | None | $22.91 | $22.91 | $26.92 |
Contra Costa Health Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $47.86 | Professional | None | $32.36 | $43.65 | $47.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $32.36 Typical High $91.20 | Professional | None | $23.99 | $32.36 | $91.20 |
Lucent Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $398.11 | Professional | None | $223.87 | $223.87 | $398.11 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $12.88 Median $26.92 Typical High $39.81 | Facility | None | $12.88 | $26.92 | $39.81 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | None | $22.91 | $22.91 | $26.92 |
Sutter Health Plus Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $50.12 | Professional | None | $17.78 | $19.95 | $50.12 |
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 $1.78 Median $1.95 Typical High $2.88 | Professional | 55 · Aftercare only | $1.78 | $1.95 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.29 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.20 | $1.29 | $1.95 |
Where California sits
The same service costs 2.5 times more in Idaho than in Kentucky. 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· 36th of 51
$25.12
ID $46.77KY $19.05
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.