How much rates vary
Facilitymedian $78 · 10th to 90th $60 to $269Professionalmedian $66 · 10th to 90th $50 to $851
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 $64.57 Typical High $117.49 | Professional | None | $60.26 | $64.57 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $91.20 | Professional | None | $63.10 | $77.62 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $229.09 Typical High $446.68 | Facility | None | $47.86 | $229.09 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $190.55 | Professional | None | $61.66 | $79.43 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | RR · Rental | $61.66 | $61.66 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $194.98 Typical High $331.13 | Facility | None | $97.72 | $194.98 | $331.13 |
Blue Shield Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $501.19 | Professional | None | $151.36 | $281.84 | $501.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $109.65 | Professional | None | $72.44 | $79.43 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Facility | None | $67.61 | $67.61 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Contra Costa Health Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $151.36 | Professional | None | $72.44 | $138.04 | $151.36 |
HealthNet Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $316.23 | Professional | None | $81.28 | $123.03 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $33.11 Median $67.61 Typical High $138.04 | Facility | None | $33.11 | $67.61 | $138.04 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Sutter Health Plus Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
United Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $77.62 | Facility | None | $67.61 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $169.82 | Professional | None | $47.86 | $60.26 | $169.82 |
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 $30.20 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 $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 $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Where California sits
The same service costs 4.1 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
$67.61
HI $209DE $51.29
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.