How much rates vary
Facilitymedian $49 · 10th to 90th $30 to $209Professionalmedian $65 · 10th to 90th $45 to $813
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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $165.96 Typical High $331.13 | Facility | None | $46.77 | $165.96 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $144.54 | Professional | None | $60.26 | $77.62 | $144.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | RR · Rental | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | UE · Used equipment | $44.67 | $44.67 | $44.67 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $239.88 | Facility | None | $95.50 | $144.54 | $239.88 |
Blue Shield Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $371.54 | Professional | None | $109.65 | $204.17 | $371.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $79.43 | Professional | None | $44.67 | $48.98 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Contra Costa Health Setting Professional Modifier None Typical Low $44.67 Median $100.00 Typical High $109.65 | Professional | None | $44.67 | $100.00 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $229.09 | Professional | None | $60.26 | $91.20 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $812.83 | Professional | None | $575.44 | $575.44 | $812.83 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $32.36 Median $61.66 Typical High $100.00 | Facility | None | $32.36 | $61.66 | $100.00 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Sutter Health Plus Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $48.98 | Facility | None | $29.51 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $125.89 | Professional | None | $46.77 | $58.88 | $125.89 |
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 $29.51 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $5.89 |
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· 27th of 51
$61.66
MT $107DE $44.67
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.