How much rates vary
Facilitymedian $54 · 10th to 90th $17 to $245Professionalmedian $59 · 10th to 90th $39 to $575
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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $61.66 | Professional | None | $53.70 | $53.70 | $61.66 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $194.98 Typical High $389.05 | Facility | None | $66.07 | $194.98 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $165.96 | Professional | None | $50.12 | $69.18 | $165.96 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $281.84 | Facility | None | $97.72 | $173.78 | $281.84 |
Blue Shield Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $436.52 | Professional | None | $128.82 | $239.88 | $436.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $93.33 | Professional | None | $72.44 | $79.43 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $269.15 | Professional | None | $72.44 | $104.71 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $53.70 Median $53.70 Typical High $117.49 | Facility | None | $53.70 | $53.70 | $117.49 |
Providence Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
United Setting Facility Modifier None Typical Low $16.98 Median $39.81 Typical High $39.81 | Facility | None | $16.98 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $147.91 | Professional | None | $40.74 | $53.70 | $147.91 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $50.12 Typical High $50.12 | Professional | RR · Rental | $5.01 | $50.12 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | UE · Used equipment | $38.02 | $38.02 | $51.29 |
Where California sits
The same service costs 3.3 times more in Hawaii 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· 23rd of 51
$57.54
HI $135DE $40.74
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.