How much rates vary
Facilitymedian $87 · 10th to 90th $69 to $309Professionalmedian $83 · 10th to 90th $55 to $977
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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $263.03 Typical High $524.81 | Facility | None | $56.23 | $263.03 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $223.87 | Professional | None | $67.61 | $91.20 | $223.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | RR · Rental | $70.79 | $70.79 | $70.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $52.48 | $52.48 | $52.48 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $223.87 Typical High $380.19 | Facility | None | $97.72 | $223.87 | $380.19 |
Blue Shield Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $575.44 | Professional | None | $173.78 | $323.59 | $575.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $125.89 | Professional | None | $74.13 | $83.18 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $173.78 | Professional | None | $74.13 | $158.49 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $363.08 | Professional | None | $95.50 | $141.25 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $38.90 Median $75.86 Typical High $158.49 | Facility | None | $38.90 | $75.86 | $158.49 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $87.10 | Facility | None | $77.62 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $194.98 | Professional | None | $54.95 | $69.18 | $194.98 |
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 $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Where California sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 19th of 51
$83.18
KS $245VT $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.