How much rates vary
Facilitymedian $91 · 10th to 90th $40 to $251Professionalmedian $55 · 10th to 90th $37 to $692
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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $151.36 Typical High $302.00 | Facility | None | $39.81 | $151.36 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $131.83 | Professional | None | $47.86 | $64.57 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $50.12 Typical High $60.26 | Professional | RR · Rental | $47.86 | $50.12 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $37.15 Typical High $48.98 | Professional | UE · Used equipment | $36.31 | $37.15 | $48.98 |
Blue Shield Setting Facility Modifier None Typical Low $87.10 Median $131.83 Typical High $218.78 | Facility | None | $87.10 | $131.83 | $218.78 |
Blue Shield Setting Professional Modifier None Typical Low $100.00 Median $186.21 Typical High $338.84 | Professional | None | $100.00 | $186.21 | $338.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $33.88 Median $37.15 Typical High $72.44 | Professional | None | $33.88 | $37.15 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None | $37.15 | $37.15 | $51.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $33.88 Median $91.20 Typical High $100.00 | Professional | None | $33.88 | $91.20 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $208.93 | Professional | None | $54.95 | $83.18 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Professional | None | $467.74 | $467.74 | $691.83 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $27.54 Median $51.29 Typical High $91.20 | Facility | None | $27.54 | $51.29 | $91.20 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None | $37.15 | $37.15 | $51.29 |
Sutter Health Plus Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $112.20 | Facility | None | $95.50 | $95.50 | $112.20 |
United Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $114.82 | Professional | None | $38.90 | $48.98 | $114.82 |
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 $24.55 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $4.90 |
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· 19th of 51
$58.88
MT $97.72DE $37.15
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.