How much rates vary
Facilitymedian $107 · 10th to 90th $89 to $437Professionalmedian $126 · 10th to 90th $81 to $1,698
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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $363.08 Typical High $724.44 | Facility | None | $85.11 | $363.08 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $309.03 | Professional | None | $107.15 | $141.25 | $309.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | RR · Rental | $107.15 | $107.15 | $107.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $81.28 | $81.28 | $81.28 |
Blue Shield Setting Facility Modifier None Typical Low $128.82 Median $309.03 Typical High $524.81 | Facility | None | $128.82 | $309.03 | $524.81 |
Blue Shield Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $794.33 | Professional | None | $239.88 | $446.68 | $794.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $173.78 | Professional | None | $77.62 | $87.10 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $77.62 Median $218.78 Typical High $239.88 | Professional | None | $77.62 | $218.78 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $426.58 | Professional | None | $131.83 | $186.21 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,202.26 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $58.88 Median $109.65 Typical High $218.78 | Facility | None | $58.88 | $109.65 | $218.78 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $107.15 | Facility | None | $89.13 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $269.15 | Professional | None | $83.18 | $107.15 | $269.15 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Where California sits
The same service costs 3.0 times more in Montana 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
$110
MT $240DE $81.28
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.