How much rates vary
Facilitymedian $60 · 10th to 90th $32 to $219Professionalmedian $68 · 10th to 90th $47 to $776
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 |
Ambetter 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 $44.67 Median $173.78 Typical High $346.74 | Facility | None | $44.67 | $173.78 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $147.91 | Professional | None | $50.12 | $74.13 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | RR · Rental | $56.23 | $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 $95.50 Median $151.36 Typical High $251.19 | Facility | None | $95.50 | $151.36 | $251.19 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $389.05 | Professional | None | $114.82 | $213.80 | $389.05 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $83.18 | Professional | None | $38.02 | $41.69 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.02 Median $104.71 Typical High $114.82 | Professional | None | $38.02 | $104.71 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $239.88 | Professional | None | $63.10 | $93.33 | $239.88 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $776.25 | Professional | None | $537.03 | $537.03 | $776.25 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $67.61 Typical High $104.71 | Facility | None | $30.90 | $67.61 | $104.71 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Sutter Health Plus Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
United Setting Facility Modifier None Typical Low $32.36 Median $60.26 Typical High $60.26 | Facility | None | $32.36 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $131.83 | Professional | None | $44.67 | $56.23 | $131.83 |
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 2.1 times more in Montana 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· 22nd of 51
$67.61
MT $107FL $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.