How much rates vary
Facilitymedian $41 · 10th to 90th $36 to $148Professionalmedian $44 · 10th to 90th $30 to $479
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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $123.03 Typical High $239.88 | Facility | None | $30.20 | $123.03 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $104.71 | Professional | None | $37.15 | $50.12 | $104.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | RR · Rental | $37.15 | $38.02 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $28.18 Typical High $28.18 | Professional | UE · Used equipment | $27.54 | $28.18 | $28.18 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $177.83 | Facility | None | $70.79 | $104.71 | $177.83 |
Blue Shield Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $269.15 | Professional | None | $81.28 | $151.36 | $269.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.84 Median $32.36 Typical High $58.88 | Professional | None | $28.84 | $32.36 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $28.84 Median $74.13 Typical High $81.28 | Professional | None | $28.84 | $74.13 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $169.82 | Professional | None | $43.65 | $66.07 | $169.82 |
Lucent Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
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 $20.89 Median $40.74 Typical High $74.13 | Facility | None | $20.89 | $40.74 | $74.13 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $40.74 | Facility | None | $36.31 | $40.74 | $40.74 |
United Setting Professional Modifier None Typical Low $29.51 Median $37.15 Typical High $91.20 | Professional | None | $29.51 | $37.15 | $91.20 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Where California sits
The same service costs 2.7 times more in Montana 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· 25th of 51
$40.74
MT $83.18DE $30.90
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.