How much rates vary
Facilitymedian $93 · 10th to 90th $56 to $251Professionalmedian $59 · 10th to 90th $47 to $912
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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $213.80 Typical High $426.58 | Facility | None | $45.71 | $213.80 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $181.97 | Professional | None | $57.54 | $74.13 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | RR · Rental | $57.54 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $309.03 | Facility | None | $97.72 | $181.97 | $309.03 |
Blue Shield Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $467.74 | Professional | None | $141.25 | $263.03 | $467.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $102.33 | Professional | None | $51.29 | $56.23 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $51.29 Median $128.82 Typical High $141.25 | Professional | None | $51.29 | $128.82 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $295.12 | Professional | None | $77.62 | $114.82 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $30.90 Median $81.28 Typical High $128.82 | Facility | None | $30.90 | $81.28 | $128.82 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $93.33 | Facility | None | $63.10 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $158.49 | Professional | None | $44.67 | $56.23 | $158.49 |
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 $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
Where California sits
The same service costs 4.4 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· 26th of 51
$63.10
HI $219FL $50.12
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.