How much rates vary
Facilitymedian $49 · 10th to 90th $21 to $135Professionalmedian $32 · 10th to 90th $22 to $363
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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $81.28 Typical High $162.18 | Facility | None | $20.89 | $81.28 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $34.67 Typical High $69.18 | Professional | None | $23.99 | $34.67 | $69.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.70 Median $26.92 Typical High $32.36 | Professional | RR · Rental | $25.70 | $26.92 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $19.95 Typical High $26.30 | Professional | UE · Used equipment | $19.50 | $19.95 | $26.30 |
Blue Shield Setting Facility Modifier None Typical Low $46.77 Median $70.79 Typical High $117.49 | Facility | None | $46.77 | $70.79 | $117.49 |
Blue Shield Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $181.97 | Professional | None | $53.70 | $100.00 | $181.97 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $6.17 Median $6.76 Typical High $38.90 | Professional | None | $6.17 | $6.76 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.17 Median $48.98 Typical High $53.70 | Professional | None | $6.17 | $48.98 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $91.20 | Professional | None | $30.90 | $38.90 | $91.20 |
Lucent Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $363.08 | Professional | None | $251.19 | $251.19 | $363.08 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $14.45 Median $33.88 Typical High $48.98 | Facility | None | $14.45 | $33.88 | $48.98 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | None | $50.12 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $61.66 | Professional | None | $20.89 | $26.30 | $61.66 |
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 $13.18 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $2.63 |
Where California sits
The same service costs 3.1 times more in Montana 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· 20th of 51
$33.88
MT $52.48KS $16.98
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.