How much rates vary
Facilitymedian $68 · 10th to 90th $58 to $257Professionalmedian $69 · 10th to 90th $44 to $741
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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $218.78 Typical High $436.52 | Facility | None | $46.77 | $218.78 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $181.97 | Professional | None | $57.54 | $77.62 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $58.88 Typical High $58.88 | Professional | RR · Rental | $57.54 | $58.88 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | UE · Used equipment | $43.65 | $43.65 | $43.65 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $186.21 Typical High $316.23 | Facility | None | $97.72 | $186.21 | $316.23 |
Blue Shield Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $478.63 | Professional | None | $144.54 | $269.15 | $478.63 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $104.71 | Professional | None | $46.77 | $51.29 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $60.26 | Professional | None | $43.65 | $43.65 | $60.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $46.77 Median $131.83 Typical High $144.54 | Professional | None | $46.77 | $131.83 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $302.00 | Professional | None | $79.43 | $109.65 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | None | $660.69 | $660.69 | $741.31 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $31.62 Median $60.26 Typical High $131.83 | Facility | None | $31.62 | $60.26 | $131.83 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $60.26 | Professional | None | $43.65 | $43.65 | $60.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
United Setting Facility Modifier None Typical Low $64.57 Median $67.61 Typical High $67.61 | Facility | None | $64.57 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $162.18 | Professional | None | $45.71 | $64.57 | $162.18 |
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 $28.84 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Where California sits
The same service costs 3.6 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· 23rd of 51
$67.61
HI $158DE $43.65
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.