How much rates vary
Facilitymedian $195 · 10th to 90th $107 to $282Professionalmedian $166 · 10th to 90th $117 to $1,995
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 $141.25 Median $141.25 Typical High $177.83 | Facility | None | $141.25 | $141.25 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | None | $141.25 | $141.25 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $562.34 | Facility | None | $104.71 | $134.90 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $389.05 | Professional | None | $120.23 | $186.21 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | RR · Rental | $144.54 | $144.54 | $144.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | UE · Used equipment | $107.15 | $107.15 | $107.15 |
Blue Shield Setting Professional Modifier None Typical Low $309.03 Median $575.44 Typical High $1,023.29 | Professional | None | $309.03 | $575.44 | $1,023.29 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $223.87 | Professional | None | $144.54 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $309.03 | Professional | None | $144.54 | $281.84 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $645.65 | Professional | None | $165.96 | $251.19 | $645.65 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,348.96 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $79.43 Median $194.98 Typical High $281.84 | Facility | None | $79.43 | $194.98 | $281.84 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Sutter Health Plus Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $346.74 | Professional | None | $112.20 | $141.25 | $346.74 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Where California sits
The same service costs 2.6 times more in Montana than in New York. 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· 37th of 51
$166
MT $275NY $107
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.