How much rates vary
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 $35.48 Median $35.48 Typical High $72.44 | Facility | None | $35.48 | $35.48 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | None | $35.48 | $35.48 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $89.13 | Facility | None | $31.62 | $41.69 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | None | $36.31 | $36.31 | $45.71 |
Blue Shield Setting Facility Modifier None Typical Low $21.88 Median $34.67 Typical High $70.79 | Facility | None | $21.88 | $34.67 | $70.79 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $190.55 | Professional | None | $114.82 | $165.96 | $190.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | None | $151.36 | $151.36 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $186.21 Typical High $281.84 | Facility | None | $93.33 | $186.21 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $151.36 | Professional | None | $40.74 | $44.67 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $281.84 | Professional | None | $56.23 | $117.49 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | None | $616.60 | $616.60 | $954.99 |
Molina Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
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 $35.48 Median $93.33 Typical High $251.19 | Facility | None | $35.48 | $93.33 | $251.19 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
United Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $70.79 | Facility | None | $23.99 | $23.99 | $70.79 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $70.79 | Professional | None | $42.66 | $42.66 | $70.79 |
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 $5.37 Median $5.37 Typical High $5.50 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.63 |
Where California sits
The same service costs 2.6 times more in Texas 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· 4th of 51
$93.33
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.