How much rates vary
Facilitymedian $110 · 10th to 90th $85 to $468Professionalmedian $148 · 10th to 90th $105 to $1,698
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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $741.31 | Facility | None | $100.00 | $371.54 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $316.23 | Professional | None | $128.82 | $147.91 | $316.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | RR · Rental | $125.89 | $125.89 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | UE · Used equipment | $95.50 | $95.50 | $102.33 |
Blue Shield Setting Facility Modifier None Typical Low $131.83 Median $323.59 Typical High $537.03 | Facility | None | $131.83 | $323.59 | $537.03 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $831.76 | Professional | None | $245.47 | $457.09 | $831.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $177.83 | Professional | None | $70.79 | $77.62 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $70.79 Median $223.87 Typical High $245.47 | Professional | None | $70.79 | $223.87 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $436.52 | Professional | None | $134.90 | $204.17 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,288.25 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $69.18 Median $173.78 Typical High $223.87 | Facility | None | $69.18 | $173.78 | $223.87 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $109.65 | Facility | None | $85.11 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $281.84 | Professional | None | $100.00 | $125.89 | $281.84 |
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 $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Where California sits
The same service costs 2.0 times more in Wisconsin 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· 24th of 51
$148
WI $257DE $129
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.