How much rates vary
Facilitymedian $204 · 10th to 90th $200 to $347Professionalmedian $288 · 10th to 90th $200 to $3,090
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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $229.09 Typical High $954.99 | Facility | None | $177.83 | $229.09 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $575.44 | Professional | None | $190.55 | $323.59 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | RR · Rental | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | UE · Used equipment | $186.21 | $186.21 | $186.21 |
Blue Shield Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $1,513.56 | Professional | None | $457.09 | $851.14 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $251.19 | Professional | None | $199.53 | $199.53 | $251.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $489.78 | Professional | None | $331.13 | $457.09 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $741.31 | Professional | None | $245.47 | $371.54 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,090.30 | Professional | None | $2,691.53 | $2,691.53 | $3,090.30 |
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 $128.82 Median $251.19 Typical High $416.87 | Facility | None | $128.82 | $251.19 | $416.87 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $251.19 | Professional | None | $199.53 | $199.53 | $251.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $524.81 | Professional | None | $190.55 | $245.47 | $524.81 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where California sits
The same service costs 3.4 times more in Montana than in New York. 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· 36th of 51
$251
MT $562NY $166
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.