How much rates vary
Facilitymedian $13 · 10th to 90th $7 to $24Professionalmedian $13 · 10th to 90th $7 to $170
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 $6.03 Median $6.61 Typical High $6.92 | Facility | None | $6.03 | $6.61 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.61 Typical High $9.77 | Professional | None | $6.03 | $6.61 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.41 Median $9.55 Typical High $38.90 | Facility | None | $7.41 | $9.55 | $38.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $15.14 Typical High $32.36 | Professional | None | $10.00 | $15.14 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | RR · Rental | $10.00 | $10.00 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | UE · Used equipment | $7.59 | $7.59 | $7.59 |
Blue Shield Setting Facility Modifier None Typical Low $23.44 Median $31.62 Typical High $46.77 | Facility | None | $23.44 | $31.62 | $46.77 |
Blue Shield Setting Professional Modifier None Typical Low $25.12 Median $46.77 Typical High $83.18 | Professional | None | $25.12 | $46.77 | $83.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $20.42 | Professional | None | $15.85 | $17.78 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $13.49 Typical High $13.49 | Facility | None | $10.00 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $18.20 Median $25.12 Typical High $27.54 | Professional | None | $18.20 | $25.12 | $27.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.80 Median $19.50 Typical High $52.48 | Professional | None | $13.80 | $19.50 | $52.48 |
Lucent Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $169.82 | Professional | None | $112.20 | $112.20 | $169.82 |
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 $6.46 Median $13.49 Typical High $22.91 | Facility | None | $6.46 | $13.49 | $22.91 |
Providence Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $8.91 Median $10.47 Typical High $28.18 | Professional | None | $8.91 | $10.47 | $28.18 |
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 $0.89 Median $1.00 Typical High $1.45 | Professional | 55 · Aftercare only | $0.89 | $1.00 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.66 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.60 | $0.66 | $0.98 |
Where California sits
The same service costs 2.8 times more in Hawaii than in Connecticut. 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· 26th of 51
$13.49
HI $27.54CT $10.00
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.