How much rates vary
Facilitymedian $39 · 10th to 90th $36 to $182Professionalmedian $46 · 10th to 90th $27 to $562
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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $131.83 Typical High $257.04 | Facility | None | $32.36 | $131.83 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $112.20 | Professional | None | $40.74 | $53.70 | $112.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | RR · Rental | $40.74 | $40.74 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | UE · Used equipment | $30.20 | $30.90 | $30.90 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $112.20 Typical High $190.55 | Facility | None | $75.86 | $112.20 | $190.55 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $288.40 | Professional | None | $91.20 | $162.18 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $63.10 | Professional | None | $38.02 | $41.69 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.02 Median $79.43 Typical High $87.10 | Professional | None | $38.02 | $79.43 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $181.97 | Professional | None | $46.77 | $57.54 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $562.34 | Professional | None | $398.11 | $398.11 | $562.34 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $22.39 Median $36.31 Typical High $79.43 | Facility | None | $22.39 | $36.31 | $79.43 |
Providence Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $97.72 | Professional | None | $32.36 | $40.74 | $97.72 |
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 $20.42 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
Where California sits
The same service costs 2.9 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· 22nd of 51
$43.65
HI $91.20DE $31.62
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.