How much rates vary
Facilitymedian $16 · 10th to 90th $13 to $66Professionalmedian $18 · 10th to 90th $12 to $234
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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.02 Median $54.95 Typical High $109.65 | Facility | None | $12.02 | $54.95 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.49 Median $19.95 Typical High $46.77 | Professional | None | $15.49 | $19.95 | $46.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | RR · Rental | $15.14 | $15.14 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.22 Median $11.22 Typical High $11.48 | Professional | UE · Used equipment | $11.22 | $11.22 | $11.48 |
Blue Shield Setting Facility Modifier None Typical Low $31.62 Median $47.86 Typical High $79.43 | Facility | None | $31.62 | $47.86 | $79.43 |
Blue Shield Setting Professional Modifier None Typical Low $36.31 Median $67.61 Typical High $123.03 | Professional | None | $36.31 | $67.61 | $123.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $11.75 Median $13.18 Typical High $26.30 | Professional | None | $11.75 | $13.18 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Contra Costa Health Setting Professional Modifier None Typical Low $11.75 Median $33.11 Typical High $36.31 | Professional | None | $11.75 | $33.11 | $36.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.95 Median $26.30 Typical High $75.86 | Professional | None | $19.95 | $26.30 | $75.86 |
Lucent Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $234.42 | Professional | None | $162.18 | $162.18 | $234.42 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
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 $8.32 Median $16.60 Typical High $33.11 | Facility | None | $8.32 | $16.60 | $33.11 |
Providence Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Sutter Health Plus Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $16.22 | Facility | None | $12.88 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $11.75 Median $16.22 Typical High $41.69 | Professional | None | $11.75 | $16.22 | $41.69 |
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 $7.41 Median $7.41 Typical High $7.41 | Professional | 52 · Reduced service | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $1.48 |
Where California sits
The same service costs 3.0 times more in Hawaii 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· 28th of 51
$16.60
HI $36.31DE $12.02
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.