How much rates vary
Facilitymedian $117 · 10th to 90th $58 to $407Professionalmedian $110 · 10th to 90th $78 to $1,288
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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $288.40 Typical High $562.34 | Facility | None | $74.13 | $288.40 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $239.88 | Professional | None | $85.11 | $100.00 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | RR · Rental | $91.20 | $93.33 | $93.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | UE · Used equipment | $69.18 | $70.79 | $70.79 |
Blue Shield Setting Facility Modifier None Typical Low $102.33 Median $245.47 Typical High $416.87 | Facility | None | $102.33 | $245.47 | $416.87 |
Blue Shield Setting Professional Modifier None Typical Low $190.55 Median $354.81 Typical High $630.96 | Professional | None | $190.55 | $354.81 | $630.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $138.04 | Professional | None | $46.77 | $51.29 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $46.77 Median $173.78 Typical High $190.55 | Professional | None | $46.77 | $173.78 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $398.11 | Professional | None | $102.33 | $154.88 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,288.25 | Professional | None | $891.25 | $891.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $51.29 Median $117.49 Typical High $173.78 | Facility | None | $51.29 | $117.49 | $173.78 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $213.80 | Professional | None | $72.44 | $93.33 | $213.80 |
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 $46.77 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $9.33 |
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· 24th of 51
$110
MT $178FL $85.11
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.