How much rates vary
Facilitymedian $155 · 10th to 90th $68 to $427Professionalmedian $100 · 10th to 90th $69 to $1,148
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $158.49 | Professional | None | $117.49 | $120.23 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $257.04 Typical High $512.86 | Facility | None | $66.07 | $257.04 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $218.78 | Professional | None | $93.33 | $109.65 | $218.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | RR · Rental | $83.18 | $83.18 | $95.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | UE · Used equipment | $63.10 | $63.10 | $69.18 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $218.78 Typical High $371.54 | Facility | None | $97.72 | $218.78 | $371.54 |
Blue Shield Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $562.34 | Professional | None | $169.82 | $316.23 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $123.03 | Professional | None | $81.28 | $89.13 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $169.82 | Professional | None | $81.28 | $154.88 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $354.81 | Professional | None | $93.33 | $138.04 | $354.81 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,148.15 | Professional | None | $794.33 | $794.33 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $100.00 Typical High $154.88 | Facility | None | $45.71 | $100.00 | $154.88 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $186.21 | Facility | None | $158.49 | $158.49 | $186.21 |
United Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $190.55 | Professional | None | $66.07 | $83.18 | $190.55 |
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 $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where California sits
The same service costs 2.2 times more in Montana than in Florida. 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· 26th of 51
$100
MT $158FL $72.44
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.