How much rates vary
Facilitymedian $36 · 10th to 90th $19 to $155Professionalmedian $51 · 10th to 90th $34 to $550
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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $85.11 | Professional | None | $43.65 | $43.65 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $51.29 | Professional | None | $44.67 | $44.67 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $123.03 Typical High $239.88 | Facility | None | $34.67 | $123.03 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $58.88 Typical High $107.15 | Professional | None | $42.66 | $58.88 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | RR · Rental | $43.65 | $43.65 | $43.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | UE · Used equipment | $31.62 | $33.11 | $33.11 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $177.83 | Facility | None | $70.79 | $104.71 | $177.83 |
Blue Shield Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $269.15 | Professional | None | $81.28 | $151.36 | $269.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $58.88 | Professional | None | $38.90 | $42.66 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $81.28 | Professional | None | $38.90 | $74.13 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $169.82 | Professional | None | $43.65 | $66.07 | $169.82 |
Lucent Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $549.54 | Professional | None | $489.78 | $489.78 | $549.54 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $23.99 Median $46.77 Typical High $74.13 | Facility | None | $23.99 | $46.77 | $74.13 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Sutter Health Plus Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $19.05 Median $36.31 Typical High $36.31 | Facility | None | $19.05 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $91.20 | Professional | None | $33.88 | $43.65 | $91.20 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Where California sits
The same service costs 2.9 times more in Kansas 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· 28th of 51
$46.77
KS $97.72DE $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.