How much rates vary
Facilitymedian $126 · 10th to 90th $55 to $347Professionalmedian $76 · 10th to 90th $51 to $955
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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | None | $67.61 | $67.61 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $208.93 Typical High $416.87 | Facility | None | $54.95 | $208.93 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $181.97 | Professional | None | $66.07 | $91.20 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $69.18 Typical High $75.86 | Professional | RR · Rental | $66.07 | $69.18 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $51.29 Typical High $67.61 | Professional | UE · Used equipment | $50.12 | $51.29 | $67.61 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $302.00 | Facility | None | $97.72 | $181.97 | $302.00 |
Blue Shield Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $467.74 | Professional | None | $138.04 | $263.03 | $467.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $102.33 | Professional | None | $63.10 | $69.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $63.10 Median $125.89 Typical High $138.04 | Professional | None | $63.10 | $125.89 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $229.09 | Professional | None | $63.10 | $97.72 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $954.99 | Professional | None | $645.65 | $645.65 | $954.99 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $38.02 Median $70.79 Typical High $125.89 | Facility | None | $38.02 | $70.79 | $125.89 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Sutter Health Plus Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $154.88 | Facility | None | $131.83 | $131.83 | $154.88 |
United Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $158.49 | Professional | None | $53.70 | $67.61 | $158.49 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where California sits
The same service costs 2.6 times more in Hawaii 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
$81.28
HI $132DE $51.29
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.