How much rates vary
Facilitymedian $89 · 10th to 90th $39 to $245Professionalmedian $56 · 10th to 90th $40 to $661
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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $147.91 Typical High $288.40 | Facility | None | $38.02 | $147.91 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $125.89 | Professional | None | $43.65 | $63.10 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | RR · Rental | $46.77 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $36.31 Typical High $46.77 | Professional | UE · Used equipment | $34.67 | $36.31 | $46.77 |
Blue Shield Setting Facility Modifier None Typical Low $85.11 Median $125.89 Typical High $213.80 | Facility | None | $85.11 | $125.89 | $213.80 |
Blue Shield Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $323.59 | Professional | None | $100.00 | $181.97 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $107.15 | Professional | None | $70.79 | $97.72 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $204.17 | Professional | None | $56.23 | $79.43 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $660.69 | Professional | None | $457.09 | $457.09 | $660.69 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $26.30 Median $56.23 Typical High $89.13 | Facility | None | $26.30 | $56.23 | $89.13 |
Providence Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $107.15 | Facility | None | $91.20 | $91.20 | $107.15 |
United Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $109.65 | Professional | None | $38.02 | $47.86 | $109.65 |
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 $23.99 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
Where California sits
The same service costs 3.1 times more in Hawaii than in Kansas. 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· 20th of 51
$56.23
HI $93.33KS $30.20
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.