How much rates vary
Facilitymedian $100 · 10th to 90th $87 to $427Professionalmedian $120 · 10th to 90th $91 to $1,862
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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | None | $109.65 | $109.65 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $338.84 Typical High $676.08 | Facility | None | $89.13 | $338.84 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $295.12 | Professional | None | $112.20 | $147.91 | $295.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | RR · Rental | $112.20 | $112.20 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | UE · Used equipment | $83.18 | $83.18 | $83.18 |
Blue Shield Setting Facility Modifier None Typical Low $120.23 Median $288.40 Typical High $489.78 | Facility | None | $120.23 | $288.40 | $489.78 |
Blue Shield Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $741.31 | Professional | None | $223.87 | $416.87 | $741.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $162.18 | Professional | None | $74.13 | $81.28 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $74.13 Median $204.17 Typical High $223.87 | Professional | None | $74.13 | $204.17 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $436.52 | Professional | None | $123.03 | $181.97 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,202.26 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $61.66 Median $125.89 Typical High $204.17 | Facility | None | $61.66 | $125.89 | $204.17 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $100.00 | Facility | None | $87.10 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $251.19 | Professional | None | $87.10 | $109.65 | $251.19 |
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 $54.95 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $10.96 |
Where California sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 27th of 51
$120
HI $219DE $91.20
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.