How much rates vary
Facilitymedian $38 · 10th to 90th $19 to $72Professionalmedian $38 · 10th to 90th $19 to $417
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 $16.98 Median $18.62 Typical High $19.50 | Facility | None | $16.98 | $18.62 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $28.84 | Professional | None | $16.98 | $18.62 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $25.70 Typical High $104.71 | Facility | None | $19.95 | $25.70 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $42.66 Typical High $93.33 | Professional | None | $26.92 | $42.66 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | RR · Rental | $26.92 | $26.92 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $89.13 Typical High $134.90 | Facility | None | $67.61 | $89.13 | $134.90 |
Blue Shield Setting Professional Modifier None Typical Low $70.79 Median $134.90 Typical High $239.88 | Professional | None | $70.79 | $134.90 | $239.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $60.26 | Professional | None | $52.48 | $58.88 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $77.62 | Professional | None | $52.48 | $70.79 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $147.91 | Professional | None | $38.90 | $45.71 | $147.91 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $416.87 | Professional | None | $331.13 | $331.13 | $416.87 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $18.20 Median $38.02 Typical High $64.57 | Facility | None | $18.20 | $38.02 | $64.57 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $81.28 | Professional | None | $25.70 | $30.20 | $81.28 |
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 $2.57 Median $2.82 Typical High $4.27 | Professional | 55 · Aftercare only | $2.57 | $2.82 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.86 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.70 | $1.86 | $2.88 |
Where California sits
The same service costs 3.0 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· 27th of 51
$38.02
HI $79.43NH $26.92
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.