How much rates vary
Facilitymedian $40 · 10th to 90th $21 to $93Professionalmedian $65 · 10th to 90th $22 to $339
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 $17.78 Median $19.50 Typical High $20.42 | Facility | None | $17.78 | $19.50 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $19.50 Typical High $28.84 | Professional | None | $17.78 | $19.50 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $67.61 | Professional | None | $47.86 | $47.86 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $39.81 Typical High $162.18 | Facility | None | $30.90 | $39.81 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $95.50 Typical High $123.03 | Professional | None | $47.86 | $95.50 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $42.66 Median $42.66 Typical High $114.82 | Professional | RR · Rental | $42.66 | $42.66 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $87.10 | Professional | UE · Used equipment | $31.62 | $31.62 | $87.10 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $93.33 Typical High $141.25 | Facility | None | $69.18 | $93.33 | $141.25 |
Blue Shield Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $251.19 | Professional | None | $74.13 | $138.04 | $251.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $309.03 | Professional | None | $70.79 | $123.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $47.86 | Facility | None | $39.81 | $39.81 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $81.28 | Professional | None | $53.70 | $74.13 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $154.88 | Professional | None | $42.66 | $60.26 | $154.88 |
Lucent Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $512.86 | Professional | None | $338.84 | $338.84 | $512.86 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $18.62 Median $39.81 Typical High $67.61 | Facility | None | $18.62 | $39.81 | $67.61 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $26.30 Median $32.36 Typical High $85.11 | Professional | None | $26.30 | $32.36 | $85.11 |
4 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 52 · Reduced service Typical Low $8.91 Median $9.77 Typical High $14.79 | Professional | 52 · Reduced service | $8.91 | $9.77 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.89 Typical High $6.03 | Professional | 53 · Discontinued | $3.55 | $3.89 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.95 Typical High $4.47 | Professional | 55 · Aftercare only | $2.69 | $2.95 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.95 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.78 | $1.95 | $3.02 |
Where California sits
The same service costs 2.3 times more in Kansas than in Alabama. 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· 12th of 51
$63.10
KS $79.43AL $33.88
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.