How much rates vary
Facilitymedian $46 · 10th to 90th $42 to $191Professionalmedian $59 · 10th to 90th $41 to $617
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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $158.49 Typical High $309.03 | Facility | None | $38.90 | $158.49 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $138.04 | Professional | None | $48.98 | $66.07 | $138.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | RR · Rental | $48.98 | $48.98 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | UE · Used equipment | $37.15 | $37.15 | $37.15 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $134.90 Typical High $229.09 | Facility | None | $91.20 | $134.90 | $229.09 |
Blue Shield Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $346.74 | Professional | None | $104.71 | $194.98 | $346.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $75.86 | Professional | None | $38.02 | $41.69 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.02 Median $93.33 Typical High $104.71 | Professional | None | $38.02 | $93.33 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $218.78 | Professional | None | $56.23 | $85.11 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $616.60 | Professional | None | $467.74 | $467.74 | $616.60 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
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 $26.92 Median $61.66 Typical High $93.33 | Facility | None | $26.92 | $61.66 | $93.33 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Sutter Health Plus Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $45.71 | Facility | None | $41.69 | $45.71 | $45.71 |
United Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $117.49 | Professional | None | $38.90 | $48.98 | $117.49 |
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 $24.55 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $4.90 |
Where California sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$57.54
HI $112AZ $44.67
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.