How much rates vary
Facilitymedian $26 · 10th to 90th $13 to $47Professionalmedian $22 · 10th to 90th $13 to $302
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 $10.47 Median $11.48 Typical High $12.02 | Facility | None | $10.47 | $11.48 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $11.48 Typical High $17.78 | Professional | None | $10.47 | $11.48 | $17.78 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $18.62 Typical High $75.86 | Facility | None | $14.45 | $18.62 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $28.18 Typical High $57.54 | Professional | None | $19.95 | $28.18 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | RR · Rental | $19.95 | $19.95 | $19.95 |
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 $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $22.39 | Professional | None | $16.22 | $22.39 | $22.39 |
Contra Costa Health Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $47.86 | Professional | None | $32.36 | $44.67 | $47.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $32.36 Typical High $93.33 | Professional | None | $23.99 | $32.36 | $93.33 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $302.00 | Professional | None | $199.53 | $199.53 | $302.00 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $11.22 Median $26.30 Typical High $39.81 | Facility | None | $11.22 | $26.30 | $39.81 |
Providence Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $26.30 | Professional | None | $16.22 | $22.39 | $26.30 |
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 $15.49 Median $18.62 Typical High $50.12 | Professional | None | $15.49 | $18.62 | $50.12 |
3 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 $1.58 Median $1.74 Typical High $2.63 | Professional | 55 · Aftercare only | $1.58 | $1.74 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.15 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.07 | $1.15 | $1.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $14.79 Typical High $20.89 | Professional | UE · Used equipment | $14.79 | $14.79 | $20.89 |
Where California sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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· 34th of 51
$22.39
HI $45.71KS $15.49
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.