How much rates vary
Facilitymedian $275 · 10th to 90th $135 to $575Professionalmedian $234 · 10th to 90th $178 to $1,778
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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | None | $199.53 | $234.42 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $275.42 Typical High $575.44 | Facility | None | $154.88 | $275.42 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $257.04 | Professional | None | $162.18 | $204.17 | $257.04 |
Blue Shield Setting Facility Modifier None Typical Low $245.47 Median $616.60 Typical High $1,000.00 | Facility | None | $245.47 | $616.60 | $1,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $501.19 | Professional | None | $208.93 | $371.54 | $501.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $257.04 Typical High $263.03 | Professional | None | $95.50 | $257.04 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $309.03 | Professional | None | $117.49 | $131.83 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $257.04 Typical High $616.60 | Professional | None | $83.18 | $257.04 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,737.80 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $275.42 Typical High $275.42 | Facility | None | $83.18 | $275.42 | $275.42 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
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 $354.81 Median $354.81 Typical High $416.87 | Facility | None | $354.81 | $354.81 | $416.87 |
United Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $426.58 | Professional | None | $173.78 | $223.87 | $426.58 |
6 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 $100.00 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $39.81 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.95 | $23.44 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.60 Median $239.88 Typical High $239.88 | Professional | RR · Rental | $16.60 | $239.88 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $177.83 Typical High $194.98 | Professional | UE · Used equipment | $125.89 | $177.83 | $194.98 |
Where California sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 14th of 51
$240
HI $417UT $162
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.