How much rates vary
Facilitymedian $50 · 10th to 90th $22 to $138Professionalmedian $32 · 10th to 90th $22 to $380
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 $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.88 Median $83.18 Typical High $165.96 | Facility | None | $21.88 | $83.18 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $72.44 | Professional | None | $27.54 | $35.48 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | RR · Rental | $27.54 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $26.92 | Professional | UE · Used equipment | $20.42 | $20.42 | $26.92 |
Blue Shield Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $120.23 | Facility | None | $47.86 | $72.44 | $120.23 |
Blue Shield Setting Professional Modifier None Typical Low $54.95 Median $104.71 Typical High $186.21 | Professional | None | $54.95 | $104.71 | $186.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $9.55 Median $10.47 Typical High $39.81 | Professional | None | $9.55 | $10.47 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $9.55 Median $50.12 Typical High $54.95 | Professional | None | $9.55 | $50.12 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $95.50 | Professional | None | $31.62 | $39.81 | $95.50 |
Lucent Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $380.19 | Professional | None | $257.04 | $257.04 | $380.19 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
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 $14.45 Median $33.88 Typical High $50.12 | Facility | None | $14.45 | $33.88 | $50.12 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $61.66 | Facility | None | $52.48 | $52.48 | $61.66 |
United Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $63.10 | Professional | None | $21.38 | $26.92 | $63.10 |
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 $13.49 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $2.69 |
Where California sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$33.88
MT $53.70AZ $24.55
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.