How much rates vary
Facilitymedian $141 · 10th to 90th $135 to $603Professionalmedian $191 · 10th to 90th $120 to $2,239
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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $478.63 Typical High $954.99 | Facility | None | $128.82 | $478.63 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $416.87 | Professional | None | $177.83 | $213.80 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | RR · Rental | $162.18 | $162.18 | $181.97 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | UE · Used equipment | $120.23 | $120.23 | $131.83 |
Blue Shield Setting Facility Modifier None Typical Low $169.82 Median $416.87 Typical High $691.83 | Facility | None | $169.82 | $416.87 | $691.83 |
Blue Shield Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $1,071.52 | Professional | None | $316.23 | $588.84 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $229.09 | Professional | None | $81.28 | $89.13 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $81.28 Median $288.40 Typical High $316.23 | Professional | None | $81.28 | $288.40 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $562.34 | Professional | None | $173.78 | $257.04 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,778.28 | $1,778.28 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $89.13 Median $165.96 Typical High $288.40 | Facility | None | $89.13 | $165.96 | $288.40 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $141.25 | Facility | None | $134.90 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $363.08 | Professional | None | $125.89 | $158.49 | $363.08 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where California sits
The same service costs 2.8 times more in Montana 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· 37th of 51
$166
MT $331DE $120
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.