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 $10.47 Median $10.47 Typical High $19.05 | Facility | None | $10.47 | $10.47 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.96 Median $13.80 Typical High $29.51 | Facility | None | $10.96 | $13.80 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $35.48 | Professional | None | $10.72 | $10.72 | $35.48 |
Blue Shield Setting Facility Modifier None Typical Low $10.72 Median $12.59 Typical High $23.44 | Facility | None | $10.72 | $12.59 | $23.44 |
Blue Shield Setting Professional Modifier None Typical Low $10.23 Median $12.02 Typical High $27.54 | Professional | None | $10.23 | $12.02 | $27.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $10.47 Median $13.80 Typical High $15.85 | Professional | None | $10.47 | $13.80 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $21.38 Typical High $32.36 | Facility | None | $10.72 | $21.38 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.96 Median $15.85 Typical High $22.91 | Professional | None | $10.96 | $15.85 | $22.91 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Providence Setting Facility Modifier None Typical Low $10.23 Median $15.14 Typical High $34.67 | Facility | None | $10.23 | $15.14 | $34.67 |
Providence Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $24.55 | Professional | None | $10.72 | $10.72 | $24.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $28.18 | Professional | None | $10.47 | $10.47 | $28.18 |
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 $1.58 Median $1.58 Typical High $1.58 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.05 |
Where California sits
The same service costs 1.7 times more in Arizona than in New York. 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
$10.96
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.