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 $26.92 Median $26.92 Typical High $31.62 | Facility | None | $26.92 | $26.92 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $57.54 | Professional | None | $26.92 | $31.62 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $138.04 Typical High $269.15 | Facility | None | $38.02 | $138.04 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $109.65 Typical High $389.05 | Professional | None | $26.30 | $109.65 | $389.05 |
Blue Shield Setting Facility Modifier None Typical Low $81.28 Median $123.03 Typical High $204.17 | Facility | None | $81.28 | $123.03 | $204.17 |
Blue Shield Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $109.65 | Professional | None | $38.02 | $54.95 | $109.65 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $83.18 | Professional | None | $54.95 | $54.95 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $93.33 | Professional | None | $54.95 | $93.33 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $239.88 | Professional | None | $75.86 | $100.00 | $239.88 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $48.98 Typical High $128.82 | Facility | None | $31.62 | $48.98 | $128.82 |
Providence Setting Professional Modifier None Typical Low $0.09 Median $85.11 Typical High $85.11 | Professional | None | $0.09 | $85.11 | $85.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $269.15 | Professional | None | $52.48 | $89.13 | $269.15 |
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 $4.07 Median $4.68 Typical High $9.12 | Professional | 55 · Aftercare only | $4.07 | $4.68 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.16 Typical High $6.03 | Professional | 56 · Pre-op care only | $2.69 | $3.16 | $6.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $75.86 Typical High $100.00 | Professional | RR · Rental | $48.98 | $75.86 | $100.00 |
Where California sits
The same service costs 5.5 times more in Iowa 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· 5th of 51
$85.11
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.