How much rates vary
Facilitymedian $72 · 10th to 90th $62 to $214Professionalmedian $66 · 10th to 90th $45 to $537
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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $87.10 | Professional | None | $60.26 | $63.10 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | None | $66.07 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $162.18 Typical High $363.08 | Facility | None | $72.44 | $162.18 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $138.04 | Professional | None | $56.23 | $74.13 | $138.04 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $234.42 | Facility | None | $95.50 | $144.54 | $234.42 |
Blue Shield Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $363.08 | Professional | None | $107.15 | $199.53 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $77.62 | Professional | None | $60.26 | $66.07 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Contra Costa Health Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $107.15 | Professional | None | $60.26 | $97.72 | $107.15 |
HealthNet Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $223.87 | Professional | None | $60.26 | $87.10 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $61.66 Median $61.66 Typical High $97.72 | Facility | None | $61.66 | $61.66 | $97.72 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Sutter Health Plus Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $123.03 | Professional | None | $45.71 | $60.26 | $123.03 |
6 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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $57.54 Typical High $57.54 | Professional | RR · Rental | $5.62 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | UE · Used equipment | $42.66 | $42.66 | $54.95 |
Where California sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 26th of 51
$69.18
WI $100NJ $47.86
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.