How much rates vary
Facilitymedian $100 · 10th to 90th $87 to $417Professionalmedian $123 · 10th to 90th $87 to $1,445
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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | None | $107.15 | $107.15 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $338.84 Typical High $676.08 | Facility | None | $85.11 | $338.84 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $288.40 | Professional | None | $107.15 | $141.25 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | RR · Rental | $107.15 | $107.15 | $107.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $79.43 | $81.28 | $81.28 |
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 $75.86 Median $83.18 Typical High $162.18 | Professional | None | $75.86 | $83.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $204.17 Typical High $223.87 | Professional | None | $75.86 | $204.17 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $407.38 | Professional | None | $123.03 | $181.97 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,174.90 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $58.88 Median $123.03 Typical High $204.17 | Facility | None | $58.88 | $123.03 | $204.17 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $83.18 Median $107.15 Typical High $251.19 | Professional | None | $83.18 | $107.15 | $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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Where California sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$123
HI $219AZ $89.13
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.