How much rates vary
Facilitymedian $83 · 10th to 90th $63 to $282Professionalmedian $76 · 10th to 90th $50 to $1,000
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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $123.03 | Professional | None | $63.10 | $63.10 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $97.72 | Professional | None | $75.86 | $97.72 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $239.88 Typical High $478.63 | Facility | None | $51.29 | $239.88 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $204.17 | Professional | None | $64.57 | $85.11 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $64.57 Median $64.57 Typical High $66.07 | Professional | RR · Rental | $64.57 | $64.57 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | UE · Used equipment | $47.86 | $47.86 | $47.86 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $208.93 Typical High $346.74 | Facility | None | $97.72 | $208.93 | $346.74 |
Blue Shield Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $524.81 | Professional | None | $158.49 | $295.12 | $524.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $114.82 | Professional | None | $75.86 | $83.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $158.49 | Professional | None | $75.86 | $144.54 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $331.13 | Professional | None | $87.10 | $123.03 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | None | $912.01 | $912.01 | $1,000.00 |
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 $35.48 Median $69.18 Typical High $144.54 | Facility | None | $35.48 | $69.18 | $144.54 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
Sutter Health Plus Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $83.18 | Facility | None | $70.79 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $181.97 | Professional | None | $50.12 | $63.10 | $181.97 |
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 $31.62 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.31 |
Where California sits
The same service costs 4.4 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· 22nd of 51
$75.86
HI $219FL $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.