How much rates vary
Facilitymedian $62 · 10th to 90th $47 to $257Professionalmedian $72 · 10th to 90th $49 to $933
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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $208.93 Typical High $416.87 | Facility | None | $48.98 | $208.93 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $181.97 | Professional | None | $60.26 | $81.28 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | RR · Rental | $61.66 | $61.66 | $61.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | UE · Used equipment | $46.77 | $46.77 | $46.77 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $302.00 | Facility | None | $97.72 | $181.97 | $302.00 |
Blue Shield Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $467.74 | Professional | None | $138.04 | $257.04 | $467.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $102.33 | Professional | None | $44.67 | $48.98 | $102.33 |
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 $44.67 Median $125.89 Typical High $138.04 | Professional | None | $44.67 | $125.89 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $288.40 | Professional | None | $75.86 | $114.82 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | None | $691.83 | $691.83 | $933.25 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $33.88 Median $66.07 Typical High $125.89 | Facility | None | $33.88 | $66.07 | $125.89 |
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 $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $61.66 | Facility | None | $46.77 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $158.49 | Professional | None | $47.86 | $61.66 | $158.49 |
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 $30.90 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
Where California sits
The same service costs 2.7 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· 25th of 51
$66.07
HI $132DE $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.