How much rates vary
Facilitymedian $468 · 10th to 90th $347 to $1,549Professionalmedian $417 · 10th to 90th $275 to $4,467
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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $1,318.26 Typical High $2,630.27 | Facility | None | $281.84 | $1,318.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $1,122.02 | Professional | None | $309.03 | $467.74 | $1,122.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | RR · Rental | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | UE · Used equipment | $263.03 | $263.03 | $263.03 |
Blue Shield Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $1,905.46 | Facility | None | $467.74 | $1,148.15 | $1,905.46 |
Blue Shield Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $2,884.03 | Professional | None | $870.96 | $1,621.81 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $630.96 | Professional | None | $346.74 | $380.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $416.87 | Facility | None | $380.19 | $380.19 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $346.74 Median $794.33 Typical High $870.96 | Professional | None | $346.74 | $794.33 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,380.38 | Professional | None | $478.63 | $645.65 | $1,380.38 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,466.84 | Professional | None | $4,265.80 | $4,265.80 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $194.98 Median $380.19 Typical High $794.33 | Facility | None | $194.98 | $380.19 | $794.33 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $389.05 Median $467.74 Typical High $467.74 | Facility | None | $389.05 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $1,000.00 | Professional | None | $275.42 | $346.74 | $1,000.00 |
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 $173.78 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $34.67 |
Where California sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 22nd of 51
$417
HI $1,023FL $275
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.