How much rates vary
Facilitymedian $170 · 10th to 90th $36 to $708Professionalmedian $224 · 10th to 90th $158 to $3,467
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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $575.44 Typical High $1,122.02 | Facility | None | $162.18 | $575.44 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $501.19 | Professional | None | $204.17 | $275.42 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | RR · Rental | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | UE · Used equipment | $154.88 | $154.88 | $154.88 |
Blue Shield Setting Facility Modifier None Typical Low $204.17 Median $489.78 Typical High $831.76 | Facility | None | $204.17 | $489.78 | $831.76 |
Blue Shield Setting Professional Modifier None Typical Low $380.19 Median $707.95 Typical High $1,258.93 | Professional | None | $380.19 | $707.95 | $1,258.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $275.42 | Professional | None | $38.90 | $42.66 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.90 Median $346.74 Typical High $380.19 | Professional | None | $38.90 | $346.74 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $630.96 | Professional | None | $204.17 | $309.03 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,467.37 | Professional | None | $2,187.76 | $2,187.76 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $109.65 Median $218.78 Typical High $346.74 | Facility | None | $109.65 | $218.78 | $346.74 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $36.31 Median $169.82 Typical High $169.82 | Facility | None | $36.31 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $426.58 | Professional | None | $158.49 | $204.17 | $426.58 |
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 $102.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Where California sits
The same service costs 3.6 times more in Georgia than in Alaska. 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
$219
GA $372AK $102
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.