How much rates vary
Facilitymedian $120 · 10th to 90th $100 to $501Professionalmedian $138 · 10th to 90th $93 to $1,950
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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $407.38 Typical High $812.83 | Facility | None | $93.33 | $407.38 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $346.74 | Professional | None | $117.49 | $158.49 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | RR · Rental | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | UE · Used equipment | $87.10 | $87.10 | $89.13 |
Blue Shield Setting Facility Modifier None Typical Low $144.54 Median $354.81 Typical High $588.84 | Facility | None | $144.54 | $354.81 | $588.84 |
Blue Shield Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $912.01 | Professional | None | $269.15 | $501.19 | $912.01 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $194.98 | Professional | None | $102.33 | $114.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $102.33 Median $245.47 Typical High $269.15 | Professional | None | $102.33 | $245.47 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $478.63 | Professional | None | $147.91 | $194.98 | $478.63 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,258.93 | $1,949.84 |
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 $64.57 Median $125.89 Typical High $245.47 | Facility | None | $64.57 | $125.89 | $245.47 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $120.23 | Facility | None | $100.00 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $309.03 | Professional | None | $91.20 | $120.23 | $309.03 |
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 $57.54 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Where California sits
The same service costs 2.9 times more in Hawaii 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· 27th of 51
$126
HI $269FL $93.33
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.