How much rates vary
Facilitymedian $62 · 10th to 90th $27 to $170Professionalmedian $35 · 10th to 90th $25 to $457
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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $64.57 | Professional | None | $33.11 | $33.11 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $51.29 | Professional | None | $30.20 | $41.69 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $102.33 Typical High $199.53 | Facility | None | $26.30 | $102.33 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $87.10 | Professional | None | $33.11 | $43.65 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $34.67 | Professional | RR · Rental | $33.11 | $33.11 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | UE · Used equipment | $25.12 | $25.12 | $25.12 |
Blue Shield Setting Facility Modifier None Typical Low $58.88 Median $89.13 Typical High $147.91 | Facility | None | $58.88 | $89.13 | $147.91 |
Blue Shield Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $223.87 | Professional | None | $67.61 | $125.89 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $72.44 | Professional | None | $48.98 | $67.61 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $141.25 | Professional | None | $36.31 | $54.95 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $457.09 | Professional | None | $316.23 | $316.23 | $457.09 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $18.20 Median $33.88 Typical High $61.66 | Facility | None | $18.20 | $33.88 | $61.66 |
Providence Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $74.13 | Facility | None | $63.10 | $63.10 | $74.13 |
United Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $75.86 | Professional | None | $25.70 | $33.11 | $75.86 |
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 $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Where California sits
The same service costs 2.8 times more in Montana 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· 24th of 51
$36.31
MT $64.57KS $23.44
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.