How much rates vary
Facilitymedian $59 · 10th to 90th $52 to $234Professionalmedian $63 · 10th to 90th $44 to $676
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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $199.53 Typical High $389.05 | Facility | None | $41.69 | $199.53 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $165.96 | Professional | None | $52.48 | $70.79 | $165.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $53.70 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $288.40 | Facility | None | $97.72 | $169.82 | $288.40 |
Blue Shield Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $436.52 | Professional | None | $131.83 | $245.47 | $436.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $95.50 | Professional | None | $50.12 | $54.95 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Contra Costa Health Setting Professional Modifier None Typical Low $50.12 Median $120.23 Typical High $131.83 | Professional | None | $50.12 | $120.23 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $275.42 | Professional | None | $70.79 | $104.71 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | None | $616.60 | $616.60 | $676.08 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $28.84 Median $63.10 Typical High $120.23 | Facility | None | $28.84 | $63.10 | $120.23 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Sutter Health Plus Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $58.88 | Facility | None | $56.23 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $147.91 | Professional | None | $41.69 | $52.48 | $147.91 |
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 $26.30 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
Where California sits
The same service costs 3.2 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
$63.10
HI $148NJ $45.71
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.