How much rates vary
Facilitymedian $69 · 10th to 90th $62 to $275Professionalmedian $69 · 10th to 90th $49 to $794
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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | None | $63.10 | $63.10 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $467.74 | Facility | None | $50.12 | $234.42 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $199.53 | Professional | None | $60.26 | $66.07 | $199.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | RR · Rental | $61.66 | $63.10 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | UE · Used equipment | $45.71 | $47.86 | $47.86 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $338.84 | Facility | None | $97.72 | $204.17 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $524.81 | Professional | None | $154.88 | $295.12 | $524.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $114.82 | Professional | None | $63.10 | $69.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Contra Costa Health Setting Professional Modifier None Typical Low $63.10 Median $141.25 Typical High $154.88 | Professional | None | $63.10 | $141.25 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $323.59 | Professional | None | $85.11 | $125.89 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | None | $707.95 | $707.95 | $794.33 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $34.67 Median $66.07 Typical High $141.25 | Facility | None | $34.67 | $66.07 | $141.25 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Sutter Health Plus Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $69.18 | Facility | None | $61.66 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $177.83 | Professional | None | $50.12 | $63.10 | $177.83 |
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 $31.62 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.31 |
Where California sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 24th of 51
$69.18
HI $174FL $48.98
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.