How much rates vary
Facilitymedian $52 · 10th to 90th $36 to $162Professionalmedian $40 · 10th to 90th $30 to $537
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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | None | $36.31 | $36.31 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $61.66 | Professional | None | $56.23 | $56.23 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $138.04 Typical High $269.15 | Facility | None | $28.84 | $138.04 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $117.49 | Professional | None | $36.31 | $47.86 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | RR · Rental | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | UE · Used equipment | $27.54 | $27.54 | $27.54 |
Blue Shield Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $199.53 | Facility | None | $79.43 | $117.49 | $199.53 |
Blue Shield Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $302.00 | Professional | None | $95.50 | $169.82 | $302.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $42.66 Median $47.86 Typical High $66.07 | Professional | None | $42.66 | $47.86 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $42.66 Median $83.18 Typical High $91.20 | Professional | None | $42.66 | $83.18 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $69.18 Typical High $190.55 | Professional | None | $48.98 | $69.18 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $19.95 Median $48.98 Typical High $83.18 | Facility | None | $19.95 | $48.98 | $83.18 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Sutter Health Plus Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $52.48 | Facility | None | $40.74 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $102.33 | Professional | None | $28.84 | $36.31 | $102.33 |
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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Where California sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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
$40.74
HI $132DC $33.11
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.