How much rates vary
Facilitymedian $102 · 10th to 90th $81 to $407Professionalmedian $93 · 10th to 90th $71 to $933
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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | None | $85.11 | $85.11 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | None | $125.89 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $302.00 Typical High $588.84 | Facility | None | $67.61 | $302.00 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $251.19 | Professional | None | $85.11 | $112.20 | $251.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | RR · Rental | $85.11 | $85.11 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | UE · Used equipment | $63.10 | $64.57 | $64.57 |
Blue Shield Setting Facility Modifier None Typical Low $107.15 Median $257.04 Typical High $436.52 | Facility | None | $107.15 | $257.04 | $436.52 |
Blue Shield Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $660.69 | Professional | None | $199.53 | $371.54 | $660.69 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $144.54 | Professional | None | $72.44 | $79.43 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $72.44 Median $177.83 Typical High $199.53 | Professional | None | $72.44 | $177.83 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $407.38 | Professional | None | $107.15 | $158.49 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | None | $933.25 | $933.25 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $46.77 Median $102.33 Typical High $177.83 | Facility | None | $46.77 | $102.33 | $177.83 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $223.87 | Professional | None | $67.61 | $85.11 | $223.87 |
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 $42.66 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.51 |
Where California sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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
$93.33
HI $214NJ $74.13
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.