How much rates vary
Facilitymedian $191 · 10th to 90th $151 to $813Professionalmedian $245 · 10th to 90th $166 to $3,548
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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $645.65 Typical High $1,288.25 | Facility | None | $173.78 | $645.65 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $549.54 | Professional | None | $218.78 | $239.88 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | RR · Rental | $218.78 | $223.87 | $223.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Blue Shield Setting Facility Modifier None Typical Low $229.09 Median $562.34 Typical High $933.25 | Facility | None | $229.09 | $562.34 | $933.25 |
Blue Shield Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $1,445.44 | Professional | None | $426.58 | $794.33 | $1,445.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $309.03 | Professional | None | $134.90 | $147.91 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $134.90 Median $389.05 Typical High $426.58 | Professional | None | $134.90 | $389.05 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $707.95 | Professional | None | $234.42 | $323.59 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,548.13 | Professional | None | $2,290.87 | $2,290.87 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $120.23 Median $229.09 Typical High $389.05 | Facility | None | $120.23 | $229.09 | $389.05 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Facility | None | $151.36 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $489.78 | Professional | None | $173.78 | $218.78 | $489.78 |
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 $109.65 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $21.88 |
Where California sits
The same service costs 2.7 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· 32nd of 51
$229
MT $457DE $170
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.