How much rates vary
Facilitymedian $1,072 · 10th to 90th $468 to $2,951Professionalmedian $631 · 10th to 90th $479 to $7,943
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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | None | $575.44 | $575.44 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | None | $831.76 | $831.76 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,778.28 Typical High $3,548.13 | Facility | None | $457.09 | $1,778.28 | $3,548.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,513.56 | Professional | None | $575.44 | $758.58 | $1,513.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $588.84 Median $588.84 Typical High $602.56 | Professional | RR · Rental | $588.84 | $588.84 | $602.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | UE · Used equipment | $436.52 | $436.52 | $436.52 |
Blue Shield Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,570.40 | Facility | None | $630.96 | $1,548.82 | $2,570.40 |
Blue Shield Setting Professional Modifier None Typical Low $1,174.90 Median $2,187.76 Typical High $3,981.07 | Professional | None | $1,174.90 | $2,187.76 | $3,981.07 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $851.14 | Professional | None | $562.34 | $616.60 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,174.90 | Professional | None | $562.34 | $1,071.52 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,862.09 | Professional | None | $645.65 | $954.99 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,943.28 | Professional | None | $5,495.41 | $5,495.41 | $7,943.28 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $724.44 Typical High $1,071.52 | Facility | None | $316.23 | $724.44 | $1,071.52 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Facility | None | $1,122.02 | $1,122.02 | $1,318.26 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $1,348.96 | Professional | None | $457.09 | $575.44 | $1,348.96 |
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 $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Where California sits
The same service costs 2.0 times more in Montana than in West Virginia. 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· 24th of 51
$692
MT $1,096WV $537
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.