How much rates vary
Facilitymedian $51 · 10th to 90th $44 to $214Professionalmedian $59 · 10th to 90th $43 to $603
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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $95.50 | Professional | None | $53.70 | $57.54 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $79.43 | Professional | None | $61.66 | $79.43 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $173.78 Typical High $346.74 | Facility | None | $43.65 | $173.78 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $151.36 | Professional | None | $52.48 | $72.44 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | RR · Rental | $54.95 | $54.95 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $251.19 | Facility | None | $95.50 | $151.36 | $251.19 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $389.05 | Professional | None | $114.82 | $213.80 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Cigna Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Contra Costa Health Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $125.89 | Professional | None | $83.18 | $114.82 | $125.89 |
HealthNet Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $239.88 | Professional | None | $66.07 | $95.50 | $239.88 |
Lucent Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $891.25 | Professional | None | $602.56 | $602.56 | $891.25 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $30.20 Median $57.54 Typical High $104.71 | Facility | None | $30.20 | $57.54 | $104.71 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Providence Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Sutter Health Plus Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $51.29 | Facility | None | $43.65 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $131.83 | Professional | None | $42.66 | $53.70 | $131.83 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where California sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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
$58.88
HI $117DE $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.