How much rates vary
Facilitymedian $55 · 10th to 90th $30 to $89Professionalmedian $40 · 10th to 90th $19 to $263
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 $25.70 Median $29.51 Typical High $33.88 | Facility | None | $25.70 | $29.51 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $29.51 Typical High $33.88 | Professional | None | $21.38 | $29.51 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $263.03 | Facility | None | $48.98 | $63.10 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $56.23 Typical High $67.61 | Professional | None | $33.11 | $56.23 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | RR · Rental | $67.61 | $67.61 | $72.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | UE · Used equipment | $51.29 | $51.29 | $58.88 |
Blue Shield Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $144.54 | Professional | None | $67.61 | $97.72 | $144.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | None | $50.12 | $50.12 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $60.26 | Professional | None | $50.12 | $60.26 | $60.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $141.25 Typical High $831.76 | Professional | None | $50.12 | $141.25 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | None | $218.78 | $218.78 | $263.03 |
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 $15.14 Median $54.95 Typical High $54.95 | Facility | None | $15.14 | $54.95 | $54.95 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
United Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $51.29 | Professional | None | $18.20 | $19.50 | $51.29 |
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 $10.72 Median $14.45 Typical High $16.98 | Professional | 52 · Reduced service | $10.72 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.89 Typical High $6.76 | Professional | 53 · Discontinued | $4.27 | $5.89 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.37 Typical High $5.13 | Professional | 55 · Aftercare only | $3.24 | $4.37 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.95 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.14 | $2.95 | $3.39 |
Where California sits
The same service costs 8.9 times more in North Dakota 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· 22nd of 51
$39.81
ND $174CO $19.50
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.