How much rates vary
Facilitymedian $51 · 10th to 90th $23 to $141Professionalmedian $33 · 10th to 90th $23 to $389
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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $87.10 Typical High $169.82 | Facility | None | $22.39 | $87.10 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $37.15 Typical High $74.13 | Professional | None | $27.54 | $37.15 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $28.18 Typical High $29.51 | Professional | RR · Rental | $27.54 | $28.18 | $29.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $21.38 Typical High $27.54 | Professional | UE · Used equipment | $20.42 | $21.38 | $27.54 |
Blue Shield Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $125.89 | Facility | None | $50.12 | $74.13 | $125.89 |
Blue Shield Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $190.55 | Professional | None | $57.54 | $107.15 | $190.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $41.69 | Professional | None | $13.80 | $15.14 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $36.31 | Professional | None | $26.30 | $26.30 | $36.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $13.80 Median $51.29 Typical High $57.54 | Professional | None | $13.80 | $51.29 | $57.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $120.23 | Professional | None | $30.90 | $46.77 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $389.05 | Professional | None | $269.15 | $269.15 | $389.05 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $15.49 Median $36.31 Typical High $51.29 | Facility | None | $15.49 | $36.31 | $51.29 |
Providence Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $36.31 | Professional | None | $26.30 | $26.30 | $36.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Facility | None | $53.70 | $53.70 | $63.10 |
United Setting Professional Modifier None Typical Low $21.88 Median $28.18 Typical High $64.57 | Professional | None | $21.88 | $28.18 | $64.57 |
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 $14.13 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Where California sits
The same service costs 2.1 times more in Montana than in Alabama. 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
$36.31
MT $54.95AL $26.30
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.