How much rates vary
Facilitymedian $135 · 10th to 90th $107 to $537Professionalmedian $145 · 10th to 90th $102 to $2,089
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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $457.09 Typical High $912.01 | Facility | None | $97.72 | $457.09 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $389.05 | Professional | None | $117.49 | $134.90 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | RR · Rental | $123.03 | $123.03 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | UE · Used equipment | $93.33 | $93.33 | $93.33 |
Blue Shield Setting Facility Modifier None Typical Low $162.18 Median $398.11 Typical High $660.69 | Facility | None | $162.18 | $398.11 | $660.69 |
Blue Shield Setting Professional Modifier None Typical Low $302.00 Median $575.44 Typical High $1,023.29 | Professional | None | $302.00 | $575.44 | $1,023.29 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $223.87 | Professional | None | $93.33 | $102.33 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $275.42 Typical High $302.00 | Professional | None | $93.33 | $275.42 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $537.03 | Professional | None | $165.96 | $223.87 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,318.26 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $67.61 Median $169.82 Typical High $275.42 | Facility | None | $67.61 | $169.82 | $275.42 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $134.90 | Facility | None | $107.15 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $346.74 | Professional | None | $97.72 | $134.90 | $346.74 |
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 $61.66 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Where California sits
The same service costs 2.7 times more in Hawaii than in Washington, DC. 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· 26th of 51
$145
HI $295DC $110
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.