How much rates vary
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | None | $83.18 | $83.18 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $234.42 Typical High $467.74 | Facility | None | $66.07 | $234.42 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $91.20 Typical High $194.98 | Professional | None | $10.47 | $91.20 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | RR · Rental | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $63.10 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $338.84 | Facility | None | $97.72 | $204.17 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $512.86 | Professional | None | $154.88 | $288.40 | $512.86 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $112.20 | Professional | None | $34.67 | $38.02 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $141.25 Typical High $154.88 | Professional | None | $34.67 | $141.25 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $323.59 | Professional | None | $85.11 | $125.89 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,318.26 | Professional | None | $933.25 | $933.25 | $1,318.26 |
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 $45.71 Median $87.10 Typical High $141.25 | Facility | None | $45.71 | $87.10 | $141.25 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Sutter Health Plus Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $69.18 | Facility | None | $39.81 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $177.83 | Professional | None | $64.57 | $83.18 | $177.83 |
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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where California sits
The same service costs 2.5 times more in Arkansas 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· 28th of 51
$87.10
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.