How much rates vary
Facilitymedian $74 · 10th to 90th $33 to $204Professionalmedian $45 · 10th to 90th $31 to $562
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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $123.03 Typical High $245.47 | Facility | None | $32.36 | $123.03 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $107.15 | Professional | None | $38.90 | $53.70 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | RR · Rental | $40.74 | $40.74 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.90 Median $30.90 Typical High $39.81 | Professional | UE · Used equipment | $30.90 | $30.90 | $39.81 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $107.15 Typical High $177.83 | Facility | None | $70.79 | $107.15 | $177.83 |
Blue Shield Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $275.42 | Professional | None | $87.10 | $154.88 | $275.42 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $17.78 Median $19.50 Typical High $60.26 | Professional | None | $17.78 | $19.50 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $17.78 Median $74.13 Typical High $81.28 | Professional | None | $17.78 | $74.13 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $141.25 | Professional | None | $39.81 | $60.26 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $562.34 | Professional | None | $389.05 | $389.05 | $562.34 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $22.39 Median $41.69 Typical High $74.13 | Facility | None | $22.39 | $41.69 | $74.13 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Sutter Health Plus Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Facility | None | $77.62 | $77.62 | $91.20 |
United Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $93.33 | Professional | None | $31.62 | $40.74 | $93.33 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
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· 20th of 51
$47.86
MT $79.43DE $30.90
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.