How much rates vary
Facilitymedian $81 · 10th to 90th $60 to $324Professionalmedian $81 · 10th to 90th $56 to $1,072
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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | None | $72.44 | $72.44 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $100.00 | Professional | None | $77.62 | $83.18 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $275.42 Typical High $549.54 | Facility | None | $58.88 | $275.42 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $234.42 | Professional | None | $74.13 | $97.72 | $234.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | RR · Rental | $74.13 | $74.13 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | UE · Used equipment | $54.95 | $54.95 | $54.95 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $239.88 Typical High $398.11 | Facility | None | $97.72 | $239.88 | $398.11 |
Blue Shield Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $616.60 | Professional | None | $181.97 | $338.84 | $616.60 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $131.83 | Professional | None | $67.61 | $75.86 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Facility | None | $77.62 | $77.62 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $67.61 Median $165.96 Typical High $181.97 | Professional | None | $67.61 | $165.96 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $380.19 | Professional | None | $100.00 | $141.25 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | None | $794.33 | $794.33 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $40.74 Median $77.62 Typical High $165.96 | Facility | None | $40.74 | $77.62 | $165.96 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
Sutter Health Plus Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
United Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $81.28 | Facility | None | $60.26 | $81.28 | $81.28 |
United Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $208.93 | Professional | None | $57.54 | $72.44 | $208.93 |
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 $36.31 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.24 |
Where California sits
The same service costs 3.1 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· 25th of 51
$81.28
HI $174DE $56.23
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.