How much rates vary
Facilitymedian $66 · 10th to 90th $29 to $182Professionalmedian $40 · 10th to 90th $27 to $490
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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $109.65 Typical High $213.80 | Facility | None | $28.18 | $109.65 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $93.33 | Professional | None | $32.36 | $46.77 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | RR · Rental | $34.67 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $26.92 Typical High $34.67 | Professional | UE · Used equipment | $25.70 | $26.92 | $34.67 |
Blue Shield Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $158.49 | Facility | None | $63.10 | $95.50 | $158.49 |
Blue Shield Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $239.88 | Professional | None | $72.44 | $134.90 | $239.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $17.38 Median $19.05 Typical High $52.48 | Professional | None | $17.38 | $19.05 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $17.38 Median $66.07 Typical High $72.44 | Professional | None | $17.38 | $66.07 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $123.03 | Professional | None | $39.81 | $56.23 | $123.03 |
Lucent Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $489.78 | Professional | None | $338.84 | $338.84 | $489.78 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
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 $19.50 Median $37.15 Typical High $66.07 | Facility | None | $19.50 | $37.15 | $66.07 |
Providence Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $79.43 | Facility | None | $67.61 | $67.61 | $79.43 |
United Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $81.28 | Professional | None | $28.18 | $35.48 | $81.28 |
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 $17.78 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.55 |
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· 21st of 51
$40.74
MT $69.18DE $26.92
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.