How much rates vary
Facilitymedian $56 · 10th to 90th $45 to $219Professionalmedian $55 · 10th to 90th $42 to $692
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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $87.10 | Professional | None | $50.12 | $50.12 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $151.36 Typical High $302.00 | Facility | None | $39.81 | $151.36 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $128.82 | Professional | None | $48.98 | $66.07 | $128.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | RR · Rental | $50.12 | $50.12 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | UE · Used equipment | $37.15 | $38.02 | $38.02 |
Blue Shield Setting Facility Modifier None Typical Low $87.10 Median $131.83 Typical High $218.78 | Facility | None | $87.10 | $131.83 | $218.78 |
Blue Shield Setting Professional Modifier None Typical Low $100.00 Median $186.21 Typical High $338.84 | Professional | None | $100.00 | $186.21 | $338.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $72.44 | Professional | None | $45.71 | $50.12 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $100.00 | Professional | None | $45.71 | $91.20 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $81.28 Typical High $208.93 | Professional | None | $54.95 | $81.28 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Professional | None | $467.74 | $467.74 | $691.83 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $27.54 Median $56.23 Typical High $91.20 | Facility | None | $27.54 | $56.23 | $91.20 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $114.82 | Professional | None | $39.81 | $50.12 | $114.82 |
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 $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
Where California sits
The same service costs 2.6 times more in Kansas than in Arizona. 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· 27th of 51
$54.95
KS $107AZ $41.69
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.