How much rates vary
Facilitymedian $78 · 10th to 90th $34 to $214Professionalmedian $47 · 10th to 90th $32 to $589
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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $128.82 Typical High $257.04 | Facility | None | $33.88 | $128.82 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $54.95 Typical High $109.65 | Professional | None | $40.74 | $54.95 | $109.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | RR · Rental | $42.66 | $42.66 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $41.69 | Professional | UE · Used equipment | $31.62 | $31.62 | $41.69 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $112.20 Typical High $186.21 | Facility | None | $74.13 | $112.20 | $186.21 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $288.40 | Professional | None | $91.20 | $158.49 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $61.66 | Professional | None | $18.20 | $19.95 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $18.20 Median $77.62 Typical High $85.11 | Professional | None | $18.20 | $77.62 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $141.25 | Professional | None | $39.81 | $61.66 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $588.84 | Professional | None | $398.11 | $398.11 | $588.84 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
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 $22.91 Median $43.65 Typical High $77.62 | Facility | None | $22.91 | $43.65 | $77.62 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Sutter Health Plus Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Facility | None | $81.28 | $81.28 | $95.50 |
United Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $97.72 | Professional | None | $33.11 | $41.69 | $97.72 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
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
$50.12
MT $83.18DE $31.62
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.