How much rates vary
Facilitymedian $38 · 10th to 90th $35 to $155Professionalmedian $39 · 10th to 90th $28 to $589
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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $128.82 Typical High $257.04 | Facility | None | $28.18 | $128.82 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $109.65 | Professional | None | $33.11 | $37.15 | $109.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | RR · Rental | $34.67 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | UE · Used equipment | $26.30 | $26.30 | $26.30 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $112.20 Typical High $190.55 | Facility | None | $75.86 | $112.20 | $190.55 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $288.40 | Professional | None | $91.20 | $162.18 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $63.10 | Professional | None | $27.54 | $30.20 | $63.10 |
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 $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $27.54 Median $77.62 Typical High $87.10 | Professional | None | $27.54 | $77.62 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $181.97 | Professional | None | $46.77 | $66.07 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $588.84 | Professional | None | $389.05 | $389.05 | $588.84 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $19.50 Median $38.90 Typical High $77.62 | Facility | None | $19.50 | $38.90 | $77.62 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $35.48 Median $38.02 Typical High $38.02 | Facility | None | $35.48 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $27.54 Median $34.67 Typical High $97.72 | Professional | None | $27.54 | $34.67 | $97.72 |
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 $17.38 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $3.47 |
Where California sits
The same service costs 3.0 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· 26th of 51
$38.90
HI $83.18DE $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.