How much rates vary
Facilitymedian $51 · 10th to 90th $32 to $145Professionalmedian $32 · 10th to 90th $27 to $550
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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $58.88 | Professional | None | $46.77 | $48.98 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $120.23 Typical High $239.88 | Facility | None | $25.70 | $120.23 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $104.71 | Professional | None | $31.62 | $43.65 | $104.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | UE · Used equipment | $23.99 | $24.55 | $24.55 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $104.71 Typical High $173.78 | Facility | None | $69.18 | $104.71 | $173.78 |
Blue Shield Setting Professional Modifier None Typical Low $79.43 Median $151.36 Typical High $269.15 | Professional | None | $79.43 | $151.36 | $269.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $58.88 | Professional | None | $28.84 | $31.62 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $28.84 Median $72.44 Typical High $79.43 | Professional | None | $28.84 | $72.44 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $165.96 | Professional | None | $43.65 | $63.10 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $17.78 Median $38.90 Typical High $72.44 | Facility | None | $17.78 | $38.90 | $72.44 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $51.29 | Facility | None | $35.48 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $91.20 | Professional | None | $25.70 | $32.36 | $91.20 |
5 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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $33.11 Typical High $33.11 | Professional | RR · Rental | $3.24 | $33.11 | $33.11 |
Where California sits
The same service costs 4.7 times more in Hawaii than in Florida. 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· 28th of 51
$35.48
HI $132FL $28.18
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.