How much rates vary
Facilitymedian $209 · 10th to 90th $166 to $302Professionalmedian $257 · 10th to 90th $170 to $2,818
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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $194.98 Typical High $794.33 | Facility | None | $151.36 | $194.98 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $588.84 | Professional | None | $169.82 | $269.15 | $588.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | RR · Rental | $208.93 | $208.93 | $208.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | UE · Used equipment | $154.88 | $154.88 | $154.88 |
Blue Shield Setting Professional Modifier None Typical Low $467.74 Median $870.96 Typical High $1,548.82 | Professional | None | $467.74 | $870.96 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $512.86 | Professional | None | $338.84 | $467.74 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $758.58 | Professional | None | $257.04 | $338.84 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,041.74 | $2,818.38 |
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 $112.20 Median $302.00 Typical High $426.58 | Facility | None | $112.20 | $302.00 | $426.58 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $524.81 | Professional | None | $162.18 | $204.17 | $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 $102.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Where California sits
The same service costs 3.0 times more in Iowa 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
$257
IA $457NY $151
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.