How much rates vary
Facilitymedian $76 · 10th to 90th $66 to $295Professionalmedian $74 · 10th to 90th $55 to $724
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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $134.90 | Professional | None | $77.62 | $102.33 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $245.47 Typical High $489.78 | Facility | None | $53.70 | $245.47 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $208.93 | Professional | None | $67.61 | $89.13 | $208.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | RR · Rental | $67.61 | $67.61 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | UE · Used equipment | $50.12 | $50.12 | $51.29 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $213.80 Typical High $363.08 | Facility | None | $97.72 | $213.80 | $363.08 |
Blue Shield Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $549.54 | Professional | None | $162.18 | $309.03 | $549.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $120.23 | Professional | None | $72.44 | $79.43 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Contra Costa Health Setting Professional Modifier None Typical Low $72.44 Median $147.91 Typical High $165.96 | Professional | None | $72.44 | $147.91 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $346.74 | Professional | None | $89.13 | $134.90 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $933.25 | Professional | None | $724.44 | $724.44 | $933.25 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $37.15 Median $89.13 Typical High $147.91 | Facility | None | $37.15 | $89.13 | $147.91 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Providence Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Sutter Health Plus Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $275.42 | Professional | None | $50.12 | $50.12 | $275.42 |
United Setting Facility Modifier None Typical Low $72.44 Median $75.86 Typical High $75.86 | Facility | None | $72.44 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $186.21 | Professional | None | $52.48 | $66.07 | $186.21 |
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 $33.11 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $6.61 |
Where California sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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· 27th of 51
$75.86
HI $166DC $58.88
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.