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 $41.69 Median $41.69 Typical High $72.44 | Facility | None | $41.69 | $41.69 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $69.18 Typical High $141.25 | Facility | None | $44.67 | $69.18 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $39.81 Typical High $89.13 | Professional | None | $23.99 | $39.81 | $89.13 |
Blue Shield Setting Facility Modifier None Typical Low $38.90 Median $45.71 Typical High $83.18 | Facility | None | $38.90 | $45.71 | $83.18 |
Blue Shield Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $112.20 | Professional | None | $41.69 | $50.12 | $112.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $61.66 | Professional | None | $37.15 | $45.71 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $74.13 Typical High $104.71 | Facility | None | $42.66 | $74.13 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $109.65 | Professional | None | $37.15 | $50.12 | $109.65 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $63.10 Typical High $104.71 | Facility | None | $41.69 | $63.10 | $104.71 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $61.66 | Professional | None | $41.69 | $41.69 | $61.66 |
Sutter Health Plus Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $109.65 | Facility | None | $41.69 | $41.69 | $109.65 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $107.15 | Professional | None | $39.81 | $39.81 | $107.15 |
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 $6.17 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
Where California sits
The same service costs 1.7 times more in Arizona than in Nebraska. 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· 12th of 51
$44.67
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.