How much rates vary
Facilitymedian $65 · 10th to 90th $32 to $170Professionalmedian $69 · 10th to 90th $33 to $832
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 $28.84 Median $31.62 Typical High $33.11 | Facility | None | $28.84 | $31.62 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $48.98 | Professional | None | $28.84 | $31.62 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $269.15 | Facility | None | $50.12 | $64.57 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $158.49 | Professional | None | $69.18 | $77.62 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | RR · Rental | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | UE · Used equipment | $51.29 | $51.29 | $51.29 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $229.09 | Facility | None | $97.72 | $147.91 | $229.09 |
Blue Shield Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $407.38 | Professional | None | $120.23 | $229.09 | $407.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $85.11 Typical High $85.11 | Facility | None | $77.62 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Contra Costa Health Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $131.83 | Professional | None | $89.13 | $120.23 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $251.19 | Professional | None | $69.18 | $100.00 | $251.19 |
Lucent Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $831.76 | Professional | None | $549.54 | $549.54 | $831.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $107.15 | Professional | None | $33.11 | $33.11 | $107.15 |
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 $29.51 Median $64.57 Typical High $109.65 | Facility | None | $29.51 | $64.57 | $109.65 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Sutter Health Plus Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $138.04 | Professional | None | $43.65 | $52.48 | $138.04 |
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 $14.45 Median $15.85 Typical High $24.55 | Professional | 52 · Reduced service | $14.45 | $15.85 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.31 Typical High $9.77 | Professional | 53 · Discontinued | $5.75 | $6.31 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.79 Typical High $7.24 | Professional | 55 · Aftercare only | $4.37 | $4.79 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.16 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.88 | $3.16 | $4.90 |
Where California sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 35th of 51
$66.07
ID $115CO $46.77
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.