How much rates vary
Facilitymedian $93 · 10th to 90th $91 to $389Professionalmedian $105 · 10th to 90th $76 to $912
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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $138.04 | Professional | None | $91.20 | $91.20 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $316.23 Typical High $630.96 | Facility | None | $72.44 | $316.23 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $269.15 | Professional | None | $93.33 | $120.23 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | RR · Rental | $91.20 | $91.20 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | UE · Used equipment | $69.18 | $69.18 | $70.79 |
Blue Shield Setting Facility Modifier None Typical Low $112.20 Median $275.42 Typical High $457.09 | Facility | None | $112.20 | $275.42 | $457.09 |
Blue Shield Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $707.95 | Professional | None | $208.93 | $389.05 | $707.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $151.36 | Professional | None | $100.00 | $109.65 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $208.93 | Professional | None | $100.00 | $190.55 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $407.38 | Professional | None | $114.82 | $173.78 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,288.25 | Professional | None | $912.01 | $912.01 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $50.12 Median $117.49 Typical High $190.55 | Facility | None | $50.12 | $117.49 | $190.55 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $239.88 | Professional | None | $72.44 | $91.20 | $239.88 |
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 $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where California sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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
$102
HI $204CO $85.11
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.