How much rates vary
Facilitymedian $120 · 10th to 90th $81 to $363Professionalmedian $87 · 10th to 90th $63 to $1,023
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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $158.49 | Professional | None | $81.28 | $87.10 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | None | $120.23 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $309.03 Typical High $602.56 | Facility | None | $64.57 | $309.03 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $107.15 Typical High $263.03 | Professional | None | $19.05 | $107.15 | $263.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | RR · Rental | $83.18 | $83.18 | $85.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | UE · Used equipment | $61.66 | $61.66 | $61.66 |
Blue Shield Setting Facility Modifier None Typical Low $109.65 Median $263.03 Typical High $446.68 | Facility | None | $109.65 | $263.03 | $446.68 |
Blue Shield Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $676.08 | Professional | None | $204.17 | $380.19 | $676.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $147.91 | Professional | None | $95.50 | $107.15 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | RR · Rental | $8.71 | $8.71 | $8.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $204.17 | Professional | None | $95.50 | $186.21 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $407.38 | Professional | None | $109.65 | $165.96 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $45.71 Median $87.10 Typical High $186.21 | Facility | None | $45.71 | $87.10 | $186.21 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Providence Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | RR · Rental | $8.71 | $8.71 | $8.71 |
Sutter Health Plus Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $338.84 | Professional | None | $50.12 | $50.12 | $338.84 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $120.23 | Facility | None | $91.20 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $229.09 | Professional | None | $64.57 | $81.28 | $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 $40.74 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Where California sits
The same service costs 5.0 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· 24th of 51
$89.13
HI $316DE $63.10
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.