How much rates vary
Facilitymedian $32 · 10th to 90th $19 to $95Professionalmedian $22 · 10th to 90th $14 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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.50 Median $52.48 Typical High $107.15 | Facility | None | $19.50 | $52.48 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $25.70 Typical High $43.65 | Professional | None | $22.39 | $25.70 | $43.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | RR · Rental | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | UE · Used equipment | $18.62 | $18.62 | $18.62 |
Blue Shield Setting Facility Modifier None Typical Low $30.20 Median $45.71 Typical High $75.86 | Facility | None | $30.20 | $45.71 | $75.86 |
Blue Shield Setting Professional Modifier None Typical Low $34.67 Median $64.57 Typical High $114.82 | Professional | None | $34.67 | $64.57 | $114.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $25.12 | Professional | None | $16.60 | $18.20 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Contra Costa Health Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $34.67 | Professional | None | $16.60 | $31.62 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.05 Median $28.18 Typical High $89.13 | Professional | None | $19.05 | $28.18 | $89.13 |
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 $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Providence Setting Facility Modifier None Typical Low $9.33 Median $25.12 Typical High $31.62 | Facility | None | $9.33 | $25.12 | $31.62 |
Providence Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Facility | None | $32.36 | $32.36 | $38.90 |
United Setting Professional Modifier None Typical Low $13.49 Median $16.98 Typical High $39.81 | Professional | None | $13.49 | $16.98 | $39.81 |
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 $8.51 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $1.70 |
Where California sits
The same service costs 2.1 times more in Minnesota 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· 15th of 51
$25.12
MN $37.15DC $17.38
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.