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 $25.70 Median $25.70 Typical High $52.48 | Facility | None | $25.70 | $25.70 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | None | $25.70 | $25.70 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $27.54 Median $30.90 Typical High $38.02 | Facility | None | $27.54 | $30.90 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $66.07 | Professional | None | $27.54 | $28.84 | $66.07 |
Blue Shield Setting Facility Modifier None Typical Low $30.20 Median $33.88 Typical High $52.48 | Facility | None | $30.20 | $33.88 | $52.48 |
Blue Shield Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $69.18 | Professional | None | $25.70 | $30.90 | $69.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $22.91 Median $28.18 Typical High $38.02 | Professional | None | $22.91 | $28.18 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $46.77 Typical High $64.57 | Facility | None | $26.30 | $46.77 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $67.61 | Professional | None | $22.91 | $33.11 | $67.61 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Providence Setting Facility Modifier None Typical Low $25.70 Median $45.71 Typical High $70.79 | Facility | None | $25.70 | $45.71 | $70.79 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $47.86 | Professional | None | $25.70 | $25.70 | $47.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $75.86 | Professional | None | $27.54 | $27.54 | $75.86 |
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 $3.80 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.80 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.51 | $2.57 | $2.57 |
Where California sits
The same service costs 1.9 times more in Alaska than in Oklahoma. 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· 10th of 51
$30.90
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.