How much rates vary
Facilitymedian $129 · 10th to 90th $63 to $537Professionalmedian $145 · 10th to 90th $100 to $1,549
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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $436.52 Typical High $870.96 | Facility | None | $97.72 | $436.52 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $380.19 | Professional | None | $123.03 | $162.18 | $380.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | RR · Rental | $123.03 | $123.03 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | UE · Used equipment | $91.20 | $91.20 | $91.20 |
Blue Shield Setting Facility Modifier None Typical Low $154.88 Median $380.19 Typical High $630.96 | Facility | None | $154.88 | $380.19 | $630.96 |
Blue Shield Setting Professional Modifier None Typical Low $288.40 Median $549.54 Typical High $977.24 | Professional | None | $288.40 | $549.54 | $977.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $213.80 | Professional | None | $114.82 | $125.89 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $114.82 Median $263.03 Typical High $288.40 | Professional | None | $114.82 | $263.03 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $512.86 | Professional | None | $158.49 | $223.87 | $512.86 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,258.93 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $67.61 Median $134.90 Typical High $263.03 | Facility | None | $67.61 | $134.90 | $263.03 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $128.82 | Facility | None | $63.10 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $331.13 | Professional | None | $95.50 | $120.23 | $331.13 |
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 $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where California sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 26th of 51
$135
KS $389NJ $100
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.