How much rates vary
Facilitymedian $32 · 10th to 90th $16 to $112Professionalmedian $35 · 10th to 90th $22 to $339
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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $28.18 | Professional | None | $26.30 | $26.30 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $44.67 | Professional | None | $41.69 | $41.69 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $100.00 Typical High $194.98 | Facility | None | $25.70 | $100.00 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $34.67 Typical High $83.18 | Professional | None | $32.36 | $34.67 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | RR · Rental | $33.11 | $33.11 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | UE · Used equipment | $24.55 | $24.55 | $24.55 |
Blue Shield Setting Facility Modifier None Typical Low $57.54 Median $87.10 Typical High $144.54 | Facility | None | $57.54 | $87.10 | $144.54 |
Blue Shield Setting Professional Modifier None Typical Low $66.07 Median $123.03 Typical High $218.78 | Professional | None | $66.07 | $123.03 | $218.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $47.86 | Professional | None | $30.90 | $33.88 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Contra Costa Health Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $66.07 | Professional | None | $30.90 | $60.26 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $138.04 | Professional | None | $37.15 | $53.70 | $138.04 |
Lucent Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | None | $323.59 | $323.59 | $338.84 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $14.45 Median $34.67 Typical High $60.26 | Facility | None | $14.45 | $34.67 | $60.26 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Sutter Health Plus Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $20.89 Median $28.84 Typical High $74.13 | Professional | None | $20.89 | $28.84 | $74.13 |
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 $13.18 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $2.63 |
Where California sits
The same service costs 3.2 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· 31st of 51
$31.62
HI $77.62DC $24.55
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.