How much rates vary
Facilitymedian $28 · 10th to 90th $18 to $79Professionalmedian $20 · 10th to 90th $15 to $251
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 $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $23.44 | Professional | None | $17.78 | $17.78 | $23.44 |
Ambetter Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $27.54 | Professional | None | $18.20 | $20.89 | $27.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $67.61 Typical High $134.90 | Facility | None | $14.45 | $67.61 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $57.54 | Professional | None | $15.85 | $23.44 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $18.62 | Professional | RR · Rental | $18.20 | $18.20 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | UE · Used equipment | $13.49 | $13.49 | $13.49 |
Blue Shield Setting Facility Modifier None Typical Low $38.90 Median $58.88 Typical High $97.72 | Facility | None | $38.90 | $58.88 | $97.72 |
Blue Shield Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $151.36 | Professional | None | $44.67 | $83.18 | $151.36 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $32.36 | Professional | None | $21.38 | $23.44 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.38 Median $40.74 Typical High $44.67 | Professional | None | $21.38 | $40.74 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $34.67 Typical High $93.33 | Professional | None | $24.55 | $34.67 | $93.33 |
Lucent Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
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 $10.00 Median $22.39 Typical High $40.74 | Facility | None | $10.00 | $22.39 | $40.74 |
Providence Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Sutter Health Plus Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $75.86 | Professional | None | $50.12 | $50.12 | $75.86 |
United Setting Facility Modifier None Typical Low $19.95 Median $28.18 Typical High $28.18 | Facility | None | $19.95 | $28.18 | $28.18 |
United Setting Professional Modifier None Typical Low $14.13 Median $17.78 Typical High $51.29 | Professional | None | $14.13 | $17.78 | $51.29 |
5 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 $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.82 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | KX · Policy requirements met | $30.20 | $30.20 | $30.20 |
Where California sits
The same service costs 3.7 times more in Hawaii 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· 25th of 51
$19.95
HI $60.26FL $16.22
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.