How much rates vary
Facilitymedian $38 · 10th to 90th $17 to $105Professionalmedian $25 · 10th to 90th $17 to $288
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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.60 Median $63.10 Typical High $125.89 | Facility | None | $16.60 | $63.10 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $26.92 Typical High $53.70 | Professional | None | $19.95 | $26.92 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | RR · Rental | $20.89 | $20.89 | $20.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $20.42 | Professional | UE · Used equipment | $15.49 | $15.49 | $20.42 |
Blue Shield Setting Facility Modifier None Typical Low $36.31 Median $54.95 Typical High $91.20 | Facility | None | $36.31 | $54.95 | $91.20 |
Blue Shield Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $141.25 | Professional | None | $41.69 | $79.43 | $141.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $30.20 | Professional | None | $19.95 | $21.88 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.95 Median $38.02 Typical High $41.69 | Professional | None | $19.95 | $38.02 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $30.20 Typical High $72.44 | Professional | None | $23.99 | $30.20 | $72.44 |
Lucent Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $288.40 | Professional | None | $194.98 | $194.98 | $288.40 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
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 $11.22 Median $25.70 Typical High $38.02 | Facility | None | $11.22 | $25.70 | $38.02 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $46.77 | Facility | None | $39.81 | $39.81 | $46.77 |
United Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $47.86 | Professional | None | $16.22 | $20.42 | $47.86 |
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 $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
Where California sits
The same service costs 2.2 times more in Montana than in New Jersey. 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· 19th of 51
$25.70
MT $40.74NJ $18.62
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.