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 $234.42 Median $234.42 Typical High $371.54 | Facility | None | $234.42 | $234.42 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | None | $234.42 | $234.42 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $812.83 | Facility | None | $251.19 | $389.05 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $501.19 | Professional | None | $128.82 | $229.09 | $501.19 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $234.42 Typical High $380.19 | Facility | None | $77.62 | $234.42 | $380.19 |
Blue Shield Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $630.96 | Professional | None | $234.42 | $281.84 | $630.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $346.74 | Professional | None | $208.93 | $257.04 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $575.44 | Facility | None | $239.88 | $416.87 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $616.60 | Professional | None | $208.93 | $275.42 | $616.60 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Providence Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $575.44 | Facility | None | $234.42 | $354.81 | $575.44 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | None | $234.42 | $234.42 | $302.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $616.60 | Facility | None | $234.42 | $234.42 | $616.60 |
United Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $616.60 | Professional | None | $229.09 | $229.09 | $616.60 |
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 $34.67 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
Where California sits
The same service costs 1.6 times more in Arizona than in Hawaii. 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· 16th of 51
$240
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.