How much rates vary
Facilitymedian $35 · 10th to 90th $15 to $95Professionalmedian $22 · 10th to 90th $16 to $263
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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $58.88 Typical High $114.82 | Facility | None | $15.14 | $58.88 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $25.12 Typical High $50.12 | Professional | None | $18.62 | $25.12 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $19.05 Typical High $22.91 | Professional | RR · Rental | $18.62 | $19.05 | $22.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $14.45 Typical High $18.62 | Professional | UE · Used equipment | $13.80 | $14.45 | $18.62 |
Blue Shield Setting Facility Modifier None Typical Low $33.88 Median $51.29 Typical High $85.11 | Facility | None | $33.88 | $51.29 | $85.11 |
Blue Shield Setting Professional Modifier None Typical Low $38.90 Median $72.44 Typical High $128.82 | Professional | None | $38.90 | $72.44 | $128.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $6.17 Median $6.76 Typical High $28.18 | Professional | None | $6.17 | $6.76 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.17 Median $35.48 Typical High $38.90 | Professional | None | $6.17 | $35.48 | $38.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $66.07 | Professional | None | $21.88 | $29.51 | $66.07 |
Lucent Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $263.03 | Professional | None | $181.97 | $181.97 | $263.03 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
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 $10.47 Median $24.55 Typical High $35.48 | Facility | None | $10.47 | $24.55 | $35.48 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $42.66 | Facility | None | $36.31 | $36.31 | $42.66 |
United Setting Professional Modifier None Typical Low $14.79 Median $19.05 Typical High $43.65 | Professional | None | $14.79 | $19.05 | $43.65 |
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 $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $1.91 |
Where California sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$24.55
MT $37.15WV $17.78
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.