How much rates vary
Facilitymedian $102 · 10th to 90th $45 to $282Professionalmedian $62 · 10th to 90th $42 to $759
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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $169.82 Typical High $338.84 | Facility | None | $43.65 | $169.82 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $72.44 Typical High $144.54 | Professional | None | $53.70 | $72.44 | $144.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $56.23 Typical High $56.23 | Professional | RR · Rental | $53.70 | $56.23 | $56.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $41.69 Typical High $54.95 | Professional | UE · Used equipment | $40.74 | $41.69 | $54.95 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $147.91 Typical High $245.47 | Facility | None | $95.50 | $147.91 | $245.47 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $380.19 | Professional | None | $112.20 | $208.93 | $380.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $81.28 | Professional | None | $21.38 | $23.44 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.38 Median $102.33 Typical High $112.20 | Professional | None | $21.38 | $102.33 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $79.43 Typical High $181.97 | Professional | None | $39.81 | $79.43 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $758.58 | Professional | None | $524.81 | $524.81 | $758.58 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $30.20 Median $57.54 Typical High $102.33 | Facility | None | $30.20 | $57.54 | $102.33 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Facility | None | $107.15 | $107.15 | $125.89 |
United Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $128.82 | Professional | None | $43.65 | $54.95 | $128.82 |
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 $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where California sits
The same service costs 2.6 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· 19th of 51
$66.07
MT $110DE $41.69
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.