How much rates vary
Facilitymedian $87 · 10th to 90th $76 to $355Professionalmedian $100 · 10th to 90th $66 to $1,000
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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $295.12 Typical High $588.84 | Facility | None | $63.10 | $295.12 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $257.04 | Professional | None | $77.62 | $107.15 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | RR · Rental | $79.43 | $79.43 | $79.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $60.26 Typical High $60.26 | Professional | UE · Used equipment | $58.88 | $60.26 | $60.26 |
Blue Shield Setting Facility Modifier None Typical Low $104.71 Median $257.04 Typical High $426.58 | Facility | None | $104.71 | $257.04 | $426.58 |
Blue Shield Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $660.69 | Professional | None | $194.98 | $371.54 | $660.69 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $144.54 | Professional | None | $93.33 | $102.33 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $199.53 | Professional | None | $93.33 | $177.83 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $407.38 | Professional | None | $107.15 | $162.18 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | None | $912.01 | $912.01 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $43.65 Median $102.33 Typical High $177.83 | Facility | None | $43.65 | $102.33 | $177.83 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $87.10 | Facility | None | $75.86 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $223.87 | Professional | None | $63.10 | $79.43 | $223.87 |
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 $39.81 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $7.94 |
Where California sits
The same service costs 3.2 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· 22nd of 51
$95.50
HI $219FL $69.18
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.