How much rates vary
Facilitymedian $129 · 10th to 90th $105 to $550Professionalmedian $174 · 10th to 90th $117 to $1,995
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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna 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 $123.03 Median $436.52 Typical High $870.96 | Facility | None | $123.03 | $436.52 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $371.54 | Professional | None | $154.88 | $169.82 | $371.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | RR · Rental | $154.88 | $158.49 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Blue Shield Setting Facility Modifier None Typical Low $154.88 Median $380.19 Typical High $630.96 | Facility | None | $154.88 | $380.19 | $630.96 |
Blue Shield Setting Professional Modifier None Typical Low $288.40 Median $537.03 Typical High $977.24 | Professional | None | $288.40 | $537.03 | $977.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $208.93 | Professional | None | $77.62 | $85.11 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $77.62 Median $263.03 Typical High $288.40 | Professional | None | $77.62 | $263.03 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $512.86 | Professional | None | $158.49 | $234.42 | $512.86 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,737.80 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $85.11 Median $162.18 Typical High $263.03 | Facility | None | $85.11 | $162.18 | $263.03 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
Sutter Health Plus Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
United Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $128.82 | Facility | None | $104.71 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $331.13 | Professional | None | $123.03 | $158.49 | $331.13 |
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 $77.62 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $15.49 |
Where California sits
The same service costs 2.8 times more in Minnesota 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· 36th of 51
$162
MN $331DE $117
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.