How much rates vary
Facilitymedian $76 · 10th to 90th $60 to $324Professionalmedian $102 · 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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $263.03 Typical High $512.86 | Facility | None | $74.13 | $263.03 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $218.78 | Professional | None | $87.10 | $100.00 | $218.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | RR · Rental | $93.33 | $93.33 | $93.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | UE · Used equipment | $69.18 | $70.79 | $70.79 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $223.87 Typical High $380.19 | Facility | None | $97.72 | $223.87 | $380.19 |
Blue Shield Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $575.44 | Professional | None | $173.78 | $323.59 | $575.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $125.89 | Professional | None | $74.13 | $81.28 | $125.89 |
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 $74.13 Median $154.88 Typical High $173.78 | Professional | None | $74.13 | $154.88 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $363.08 | Professional | None | $93.33 | $141.25 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $51.29 Median $100.00 Typical High $154.88 | Facility | None | $51.29 | $100.00 | $154.88 |
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 $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $75.86 | Facility | None | $60.26 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $199.53 | Professional | None | $72.44 | $93.33 | $199.53 |
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 $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where California sits
The same service costs 2.9 times more in Montana than in Florida. 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· 29th of 51
$100
MT $209FL $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.