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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.11 Median $125.89 Typical High $251.19 | Facility | None | $33.11 | $125.89 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $107.15 | Professional | None | $41.69 | $53.70 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | RR · Rental | $41.69 | $41.69 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
Blue Shield Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $181.97 | Facility | None | $72.44 | $109.65 | $181.97 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $281.84 | Professional | None | $89.13 | $154.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $91.20 | Professional | None | $60.26 | $83.18 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $173.78 | Professional | None | $45.71 | $64.57 | $173.78 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $562.34 | Professional | None | $389.05 | $389.05 | $562.34 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Providence Setting Facility Modifier None Typical Low $22.39 Median $43.65 Typical High $75.86 | Facility | None | $22.39 | $43.65 | $75.86 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Sutter Health Plus Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Facility | None | $79.43 | $79.43 | $93.33 |
United Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $95.50 | Professional | None | $32.36 | $40.74 | $95.50 |
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 $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
Where California sits
The same service costs 2.2 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· 22nd of 51
$48.98
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.