How much rates vary
Facilitymedian $28 · 10th to 90th $22 to $72Professionalmedian $21 · 10th to 90th $14 to $191
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 $18.62 Median $21.38 Typical High $24.55 | Facility | None | $18.62 | $21.38 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $21.38 Typical High $24.55 | Professional | None | $15.49 | $21.38 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $51.29 Typical High $213.80 | Facility | None | $39.81 | $51.29 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $31.62 Typical High $54.95 | Professional | None | $21.38 | $31.62 | $54.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $54.95 Median $54.95 Typical High $58.88 | Professional | RR · Rental | $54.95 | $54.95 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | UE · Used equipment | $40.74 | $40.74 | $48.98 |
Blue Shield Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $104.71 | Professional | None | $48.98 | $70.79 | $104.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | None | $38.90 | $38.90 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $46.77 | Professional | None | $38.90 | $46.77 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $141.25 Typical High $831.76 | Professional | None | $38.90 | $141.25 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | None | $162.18 | $162.18 | $190.55 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $10.72 Median $28.18 Typical High $32.36 | Facility | None | $10.72 | $28.18 | $32.36 |
Providence Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
United Setting Professional Modifier None Typical Low $13.18 Median $14.13 Typical High $36.31 | Professional | None | $13.18 | $14.13 | $36.31 |
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 $7.76 Median $10.72 Typical High $12.30 | Professional | 52 · Reduced service | $7.76 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $4.27 Typical High $4.90 | Professional | 53 · Discontinued | $3.09 | $4.27 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $3.16 Typical High $3.72 | Professional | 55 · Aftercare only | $2.29 | $3.16 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.14 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.55 | $2.14 | $2.45 |
Where California sits
The same service costs 8.7 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· 23rd of 51
$21.38
HI $85.11KS $9.77
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.