How much rates vary
Facilitymedian $72 · 10th to 90th $65 to $288Professionalmedian $78 · 10th to 90th $54 to $832
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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $245.47 Typical High $478.63 | Facility | None | $51.29 | $245.47 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $208.93 | Professional | None | $63.10 | $85.11 | $208.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | RR · Rental | $66.07 | $66.07 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | UE · Used equipment | $47.86 | $48.98 | $48.98 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $208.93 Typical High $354.81 | Facility | None | $97.72 | $208.93 | $354.81 |
Blue Shield Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $537.03 | Professional | None | $162.18 | $302.00 | $537.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $57.54 Median $63.10 Typical High $117.49 | Professional | None | $57.54 | $63.10 | $117.49 |
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 $57.54 Median $147.91 Typical High $162.18 | Professional | None | $57.54 | $147.91 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $338.84 | Professional | None | $87.10 | $125.89 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
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 $35.48 Median $75.86 Typical High $147.91 | Facility | None | $35.48 | $75.86 | $147.91 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $72.44 | Facility | None | $69.18 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $181.97 | Professional | None | $51.29 | $64.57 | $181.97 |
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 $32.36 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.46 |
Where California sits
The same service costs 3.1 times more in Hawaii 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· 23rd of 51
$75.86
HI $170NJ $54.95
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.