How much rates vary
Facilitymedian $100 · 10th to 90th $59 to $263Professionalmedian $63 · 10th to 90th $49 to $1,072
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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | None | $58.88 | $58.88 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $107.15 | Professional | None | $74.13 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $218.78 Typical High $436.52 | Facility | None | $46.77 | $218.78 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $186.21 | Professional | None | $58.88 | $77.62 | $186.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | RR · Rental | $58.88 | $58.88 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | UE · Used equipment | $44.67 | $44.67 | $44.67 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $190.55 Typical High $323.59 | Facility | None | $97.72 | $190.55 | $323.59 |
Blue Shield Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $489.78 | Professional | None | $144.54 | $275.42 | $489.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $107.15 | Professional | None | $69.18 | $75.86 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $147.91 | Professional | None | $69.18 | $131.83 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $309.03 | Professional | None | $79.43 | $114.82 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $32.36 Median $72.44 Typical High $131.83 | Facility | None | $32.36 | $72.44 | $131.83 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $100.00 | Facility | None | $64.57 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $165.96 | Professional | None | $46.77 | $58.88 | $165.96 |
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 $29.51 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.75 | $11.75 | $11.75 |
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 $5.89 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $5.89 |
Where California sits
The same service costs 5.0 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· 29th of 51
$64.57
HI $257FL $51.29
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.