How much rates vary
Facilitymedian $60 · 10th to 90th $50 to $245Professionalmedian $74 · 10th to 90th $47 to $794
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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $204.17 Typical High $407.38 | Facility | None | $50.12 | $204.17 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $173.78 | Professional | None | $60.26 | $85.11 | $173.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | RR · Rental | $60.26 | $63.10 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | UE · Used equipment | $45.71 | $46.77 | $46.77 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $177.83 Typical High $295.12 | Facility | None | $97.72 | $177.83 | $295.12 |
Blue Shield Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $457.09 | Professional | None | $134.90 | $251.19 | $457.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $97.72 | Professional | None | $44.67 | $48.98 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Contra Costa Health Setting Professional Modifier None Typical Low $44.67 Median $123.03 Typical High $134.90 | Professional | None | $44.67 | $123.03 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $281.84 | Professional | None | $74.13 | $109.65 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $794.33 | Professional | None | $645.65 | $645.65 | $794.33 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $33.88 Median $64.57 Typical High $123.03 | Facility | None | $33.88 | $64.57 | $123.03 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Sutter Health Plus Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $60.26 | Facility | None | $50.12 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $154.88 | Professional | None | $48.98 | $61.66 | $154.88 |
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 $30.90 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
Where California sits
The same service costs 2.8 times more in Wisconsin 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
$64.57
WI $132DE $46.77
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.