How much rates vary
Facilitymedian $21 · 10th to 90th $15 to $78Professionalmedian $20 · 10th to 90th $15 to $331
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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $29.51 | Professional | None | $15.14 | $15.14 | $29.51 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $21.38 Typical High $89.13 | Facility | None | $16.98 | $21.38 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $48.98 | Professional | None | $16.98 | $16.98 | $48.98 |
Blue Shield Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $112.20 | Professional | None | $34.67 | $53.70 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $66.07 | Professional | None | $48.98 | $53.70 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $131.83 | Professional | None | $43.65 | $52.48 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | None | $331.13 | $331.13 | $363.08 |
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 $15.14 Median $48.98 Typical High $77.62 | Facility | None | $15.14 | $48.98 | $77.62 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $19.05 Median $20.42 Typical High $60.26 | Professional | None | $19.05 | $20.42 | $60.26 |
7 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 $7.59 Median $7.59 Typical High $14.45 | Professional | 52 · Reduced service | $7.59 | $7.59 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $5.75 | Professional | 53 · Discontinued | $3.02 | $3.02 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $11.48 Typical High $21.88 | Professional | 54 · Surgery only | $11.48 | $11.48 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $4.37 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $2.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $4.79 Typical High $21.88 | Professional | RR · Rental | $3.63 | $4.79 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $35.48 Typical High $165.96 | Professional | UE · Used equipment | $27.54 | $35.48 | $165.96 |
Where California sits
The same service costs 2.8 times more in Hawaii 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· 48th of 51
$19.95
HI $51.29NY $18.62
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.