How much rates vary
Facilitymedian $132 · 10th to 90th $107 to $537Professionalmedian $158 · 10th to 90th $112 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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $446.68 Typical High $870.96 | Facility | None | $107.15 | $446.68 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $371.54 | Professional | None | $138.04 | $177.83 | $371.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | RR · Rental | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | UE · Used equipment | $102.33 | $102.33 | $102.33 |
Blue Shield Setting Facility Modifier None Typical Low $158.49 Median $380.19 Typical High $645.65 | Facility | None | $158.49 | $380.19 | $645.65 |
Blue Shield Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $977.24 | Professional | None | $295.12 | $549.54 | $977.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $213.80 | Professional | None | $95.50 | $107.15 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $95.50 Median $269.15 Typical High $295.12 | Professional | None | $95.50 | $269.15 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $524.81 | Professional | None | $158.49 | $213.80 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,513.56 | $1,513.56 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $74.13 Median $158.49 Typical High $269.15 | Facility | None | $74.13 | $158.49 | $269.15 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
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 $107.15 Median $131.83 Typical High $131.83 | Facility | None | $107.15 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $331.13 | Professional | None | $107.15 | $134.90 | $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 $67.61 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
Where California sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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· 22nd of 51
$158
HI $282NJ $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.