How much rates vary
Facilitymedian $69 · 10th to 90th $40 to $295Professionalmedian $93 · 10th to 90th $66 to $1,072
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $234.42 Typical High $467.74 | Facility | None | $67.61 | $234.42 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $204.17 | Professional | None | $81.28 | $109.65 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | RR · Rental | $81.28 | $85.11 | $85.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $61.66 | $63.10 | $63.10 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $338.84 | Facility | None | $97.72 | $204.17 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $524.81 | Professional | None | $154.88 | $295.12 | $524.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $114.82 | Professional | None | $39.81 | $43.65 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Contra Costa Health Setting Professional Modifier None Typical Low $39.81 Median $141.25 Typical High $154.88 | Professional | None | $39.81 | $141.25 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $331.13 | Professional | None | $85.11 | $128.82 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | None | $851.14 | $851.14 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $46.77 Median $91.20 Typical High $141.25 | Facility | None | $46.77 | $91.20 | $141.25 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Sutter Health Plus Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $69.18 | Facility | None | $39.81 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $177.83 | Professional | None | $66.07 | $83.18 | $177.83 |
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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where California sits
The same service costs 2.5 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· 23rd of 51
$91.20
MT $162DE $66.07
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.