How much rates vary
Facilitymedian $63 · 10th to 90th $58 to $257Professionalmedian $63 · 10th to 90th $46 to $832
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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $112.20 | Professional | None | $57.54 | $57.54 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $104.71 | Professional | None | $58.88 | $75.86 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $213.80 Typical High $426.58 | Facility | None | $45.71 | $213.80 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $186.21 | Professional | None | $54.95 | $75.86 | $186.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | RR · Rental | $57.54 | $57.54 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | UE · Used equipment | $43.65 | $43.65 | $43.65 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $186.21 Typical High $316.23 | Facility | None | $97.72 | $186.21 | $316.23 |
Blue Shield Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $478.63 | Professional | None | $144.54 | $269.15 | $478.63 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $104.71 | Professional | None | $60.26 | $66.07 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Contra Costa Health Setting Professional Modifier None Typical Low $60.26 Median $128.82 Typical High $144.54 | Professional | None | $60.26 | $128.82 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $302.00 | Professional | None | $77.62 | $109.65 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | None | $724.44 | $724.44 | $831.76 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $31.62 Median $63.10 Typical High $128.82 | Facility | None | $31.62 | $63.10 | $128.82 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Sutter Health Plus Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
United Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $63.10 | Facility | None | $60.26 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $162.18 | Professional | None | $45.71 | $57.54 | $162.18 |
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 $28.84 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Where California sits
The same service costs 3.8 times more in Hawaii 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· 28th of 51
$63.10
HI $174FL $45.71
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.