How much rates vary
Facilitymedian $89 · 10th to 90th $79 to $363Professionalmedian $95 · 10th to 90th $71 to $871
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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $125.89 | Professional | None | $87.10 | $93.33 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $223.87 | Professional | None | $123.03 | $131.83 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $302.00 Typical High $602.56 | Facility | None | $70.79 | $302.00 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $95.50 Typical High $257.04 | Professional | None | $37.15 | $95.50 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | RR · Rental | $89.13 | $89.13 | $91.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | UE · Used equipment | $66.07 | $66.07 | $66.07 |
Blue Shield Setting Facility Modifier None Typical Low $107.15 Median $263.03 Typical High $436.52 | Facility | None | $107.15 | $263.03 | $436.52 |
Blue Shield Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $676.08 | Professional | None | $199.53 | $371.54 | $676.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $144.54 | Professional | None | $81.28 | $89.13 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $97.72 | Facility | None | $95.50 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $199.53 | Professional | None | $81.28 | $181.97 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $407.38 | Professional | None | $109.65 | $162.18 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,258.93 | Professional | None | $870.96 | $870.96 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $48.98 Median $97.72 Typical High $181.97 | Facility | None | $48.98 | $97.72 | $181.97 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $89.13 | Facility | None | $79.43 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $229.09 | Professional | None | $69.18 | $87.10 | $229.09 |
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 $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Where California sits
The same service costs 2.8 times more in Hawaii than in Florida. 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· 28th of 51
$95.50
HI $195FL $70.79
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.