How much rates vary
Facilitymedian $59 · 10th to 90th $26 to $162Professionalmedian $35 · 10th to 90th $25 to $447
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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $97.72 Typical High $194.98 | Facility | None | $25.70 | $97.72 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $85.11 | Professional | None | $31.62 | $42.66 | $85.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $31.62 Median $32.36 Typical High $37.15 | Professional | RR · Rental | $31.62 | $32.36 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $24.55 Typical High $31.62 | Professional | UE · Used equipment | $23.99 | $24.55 | $31.62 |
Blue Shield Setting Facility Modifier None Typical Low $57.54 Median $85.11 Typical High $144.54 | Facility | None | $57.54 | $85.11 | $144.54 |
Blue Shield Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $218.78 | Professional | None | $64.57 | $123.03 | $218.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $10.23 Median $11.48 Typical High $47.86 | Professional | None | $10.23 | $11.48 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.23 Median $58.88 Typical High $66.07 | Professional | None | $10.23 | $58.88 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $112.20 | Professional | None | $37.15 | $47.86 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $446.68 | Professional | None | $309.03 | $309.03 | $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 $17.78 Median $33.11 Typical High $58.88 | Facility | None | $17.78 | $33.11 | $58.88 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $72.44 | Facility | None | $61.66 | $61.66 | $72.44 |
United Setting Professional Modifier None Typical Low $25.12 Median $32.36 Typical High $74.13 | Professional | None | $25.12 | $32.36 | $74.13 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where California sits
The same service costs 2.8 times more in Kansas 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· 20th of 51
$38.02
KS $69.18DE $24.55
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.