How much rates vary
Facilitymedian $112 · 10th to 90th $98 to $479Professionalmedian $120 · 10th to 90th $83 to $1,023
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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $158.49 | Professional | None | $107.15 | $114.82 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $331.13 Typical High $645.65 | Facility | None | $87.10 | $331.13 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $281.84 | Professional | None | $109.65 | $144.54 | $281.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | RR · Rental | $109.65 | $109.65 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | UE · Used equipment | $81.28 | $83.18 | $83.18 |
Blue Shield Setting Facility Modifier None Typical Low $117.49 Median $281.84 Typical High $478.63 | Facility | None | $117.49 | $281.84 | $478.63 |
Blue Shield Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $724.44 | Professional | None | $218.78 | $407.38 | $724.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $158.49 | Professional | None | $100.00 | $109.65 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Cigna Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | RR · Rental | $11.22 | $11.22 | $11.22 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $218.78 | Professional | None | $100.00 | $199.53 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $407.38 | Professional | None | $117.49 | $158.49 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,023.29 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $60.26 Median $112.20 Typical High $199.53 | Facility | None | $60.26 | $112.20 | $199.53 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Providence Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | RR · Rental | $11.22 | $11.22 | $11.22 |
Sutter Health Plus Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $245.47 | Professional | None | $85.11 | $109.65 | $245.47 |
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 $53.70 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Where California sits
The same service costs 2.3 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· 25th of 51
$120
HI $200DE $85.11
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.