How much rates vary
Facilitymedian $85 · 10th to 90th $72 to $363Professionalmedian $120 · 10th to 90th $85 to $1,413
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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $288.40 Typical High $575.44 | Facility | None | $81.28 | $288.40 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $251.19 | Professional | None | $100.00 | $134.90 | $251.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | RR · Rental | $100.00 | $102.33 | $102.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | UE · Used equipment | $74.13 | $77.62 | $77.62 |
Blue Shield Setting Facility Modifier None Typical Low $102.33 Median $251.19 Typical High $416.87 | Facility | None | $102.33 | $251.19 | $416.87 |
Blue Shield Setting Professional Modifier None Typical Low $190.55 Median $354.81 Typical High $630.96 | Professional | None | $190.55 | $354.81 | $630.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $138.04 | Professional | None | $61.66 | $67.61 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $61.66 Median $173.78 Typical High $190.55 | Professional | None | $61.66 | $173.78 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $398.11 | Professional | None | $104.71 | $154.88 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
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 $56.23 Median $120.23 Typical High $173.78 | Facility | None | $56.23 | $120.23 | $173.78 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $85.11 | Facility | None | $72.44 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $213.80 | Professional | None | $81.28 | $102.33 | $213.80 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.23 |
Where California sits
The same service costs 2.4 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· 26th of 51
$112
MT $209DE $87.10
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.