How much rates vary
Facilitymedian $46 · 10th to 90th $20 to $126Professionalmedian $27 · 10th to 90th $20 to $347
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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $75.86 Typical High $151.36 | Facility | None | $19.95 | $75.86 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $64.57 | Professional | None | $23.99 | $26.30 | $64.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $25.70 | Professional | RR · Rental | $25.12 | $25.12 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.20 Median $18.62 Typical High $24.55 | Professional | UE · Used equipment | $18.20 | $18.62 | $24.55 |
Blue Shield Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $109.65 | Facility | None | $43.65 | $66.07 | $109.65 |
Blue Shield Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $169.82 | Professional | None | $50.12 | $95.50 | $169.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.90 Median $5.37 Typical High $36.31 | Professional | None | $4.90 | $5.37 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.90 Median $45.71 Typical High $50.12 | Professional | None | $4.90 | $45.71 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $85.11 | Professional | None | $28.84 | $38.90 | $85.11 |
Lucent Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $346.74 | Professional | None | $234.42 | $234.42 | $346.74 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
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 $13.49 Median $26.92 Typical High $45.71 | Facility | None | $13.49 | $26.92 | $45.71 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Sutter Health Plus Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $56.23 | Facility | None | $47.86 | $47.86 | $56.23 |
United Setting Professional Modifier None Typical Low $19.50 Median $24.55 Typical High $57.54 | Professional | None | $19.50 | $24.55 | $57.54 |
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 $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Where California sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$27.54
MT $48.98DE $19.95
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.