How much rates vary
Facilitymedian $191 · 10th to 90th $85 to $525Professionalmedian $110 · 10th to 90th $79 to $1,445
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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $316.23 Typical High $630.96 | Facility | None | $83.18 | $316.23 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $275.42 | Professional | None | $100.00 | $138.04 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $100.00 Median $104.71 Typical High $117.49 | Professional | RR · Rental | $100.00 | $104.71 | $117.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $79.43 Typical High $102.33 | Professional | UE · Used equipment | $75.86 | $79.43 | $102.33 |
Blue Shield Setting Facility Modifier None Typical Low $112.20 Median $275.42 Typical High $457.09 | Facility | None | $112.20 | $275.42 | $457.09 |
Blue Shield Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $707.95 | Professional | None | $208.93 | $398.11 | $707.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $20.42 Median $22.91 Typical High $154.88 | Professional | None | $20.42 | $22.91 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $20.42 Median $190.55 Typical High $213.80 | Professional | None | $20.42 | $190.55 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $141.25 Typical High $346.74 | Professional | None | $39.81 | $141.25 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,000.00 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $57.54 Median $107.15 Typical High $190.55 | Facility | None | $57.54 | $107.15 | $190.55 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Facility | None | $199.53 | $199.53 | $234.42 |
United Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $239.88 | Professional | None | $81.28 | $104.71 | $239.88 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
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
$115
MT $204DE $79.43
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.