How much rates vary
Facilitymedian $107 · 10th to 90th $95 to $427Professionalmedian $115 · 10th to 90th $72 to $1,230
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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $363.08 Typical High $707.95 | Facility | None | $75.86 | $363.08 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $302.00 | Professional | None | $95.50 | $125.89 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | RR · Rental | $95.50 | $97.72 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | UE · Used equipment | $72.44 | $72.44 | $72.44 |
Blue Shield Setting Facility Modifier None Typical Low $128.82 Median $309.03 Typical High $524.81 | Facility | None | $128.82 | $309.03 | $524.81 |
Blue Shield Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $794.33 | Professional | None | $239.88 | $446.68 | $794.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $173.78 | Professional | None | $89.13 | $97.72 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $89.13 Median $218.78 Typical High $239.88 | Professional | None | $89.13 | $218.78 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $426.58 | Professional | None | $128.82 | $194.98 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,202.26 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $52.48 Median $100.00 Typical High $218.78 | Facility | None | $52.48 | $100.00 | $218.78 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $107.15 | Facility | None | $102.33 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $269.15 | Professional | None | $75.86 | $107.15 | $269.15 |
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 $47.86 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $9.55 |
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
$107
HI $295DE $72.44
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.