How much rates vary
Facilitymedian $115 · 10th to 90th $83 to $372Professionalmedian $87 · 10th to 90th $66 to $1,413
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $316.23 Typical High $616.60 | Facility | None | $66.07 | $316.23 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $269.15 | Professional | None | $85.11 | $109.65 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | RR · Rental | $85.11 | $85.11 | $85.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $63.10 |
Blue Shield Setting Facility Modifier None Typical Low $112.20 Median $269.15 Typical High $457.09 | Facility | None | $112.20 | $269.15 | $457.09 |
Blue Shield Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $691.83 | Professional | None | $208.93 | $389.05 | $691.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $151.36 | Professional | None | $97.72 | $109.65 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $208.93 | Professional | None | $97.72 | $190.55 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $407.38 | Professional | None | $112.20 | $169.82 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $45.71 Median $89.13 Typical High $190.55 | Facility | None | $45.71 | $89.13 | $190.55 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $114.82 | Facility | None | $93.33 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $234.42 | Professional | None | $66.07 | $83.18 | $234.42 |
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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
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 $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where California sits
The same service costs 5.1 times more in Hawaii 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· 22nd of 51
$93.33
HI $339DE $66.07
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.