How much rates vary
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 $43.65 Median $48.98 Typical High $57.54 | Facility | None | $43.65 | $48.98 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $48.98 Typical High $57.54 | Professional | None | $36.31 | $48.98 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $46.77 Typical High $190.55 | Facility | None | $36.31 | $46.77 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $74.13 | Professional | None | $50.12 | $50.12 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | RR · Rental | $50.12 | $50.12 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | UE · Used equipment | $37.15 | $37.15 | $44.67 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $245.47 | Professional | None | $114.82 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Contra Costa Health Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $53.70 | Professional | None | $44.67 | $53.70 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $630.96 | Professional | None | $44.67 | $54.95 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | None | $371.54 | $371.54 | $446.68 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $25.12 Median $50.12 Typical High $74.13 | Facility | None | $25.12 | $50.12 | $74.13 |
Providence Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
United Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $85.11 | Professional | None | $30.90 | $33.11 | $85.11 |
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 $18.20 Median $24.55 Typical High $28.84 | Professional | 52 · Reduced service | $18.20 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $9.77 Typical High $11.48 | Professional | 53 · Discontinued | $7.24 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.41 Typical High $8.51 | Professional | 55 · Aftercare only | $5.37 | $7.41 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.90 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.63 | $4.90 | $5.75 |
Where California sits
The same service costs 4.1 times more in Kansas than in Colorado. 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· 23rd of 51
$48.98
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.