How much rates vary
Facilitymedian $562 · 10th to 90th $245 to $1,549Professionalmedian $331 · 10th to 90th $229 to $2,884
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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $380.19 | Professional | None | $302.00 | $302.00 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $933.25 Typical High $1,862.09 | Facility | None | $239.88 | $933.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $794.33 | Professional | None | $229.09 | $398.11 | $794.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $234.42 Median $309.03 Typical High $309.03 | Professional | RR · Rental | $234.42 | $309.03 | $309.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | UE · Used equipment | $199.53 | $229.09 | $229.09 |
Blue Shield Setting Facility Modifier None Typical Low $331.13 Median $812.83 Typical High $1,348.96 | Facility | None | $331.13 | $812.83 | $1,348.96 |
Blue Shield Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $2,089.30 | Professional | None | $616.60 | $1,148.15 | $2,089.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $446.68 | Professional | None | $295.12 | $323.59 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $616.60 | Professional | None | $295.12 | $562.34 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $977.24 | Professional | None | $338.84 | $501.19 | $977.24 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $4,168.69 | Professional | None | $2,884.03 | $2,884.03 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $165.96 Median $316.23 Typical High $562.34 | Facility | None | $165.96 | $316.23 | $562.34 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Facility | None | $588.84 | $588.84 | $691.83 |
United Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $707.95 | Professional | None | $239.88 | $302.00 | $707.95 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Where California sits
The same service costs 2.6 times more in Montana 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· 25th of 51
$331
MT $589DE $229
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.