How much rates vary
Facilitymedian $209 · 10th to 90th $174 to $776Professionalmedian $204 · 10th to 90th $145 to $2,188
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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $645.65 Typical High $1,288.25 | Facility | None | $138.04 | $645.65 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $549.54 | Professional | None | $173.78 | $234.42 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | RR · Rental | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | UE · Used equipment | $131.83 | $131.83 | $131.83 |
Blue Shield Setting Facility Modifier None Typical Low $229.09 Median $562.34 Typical High $933.25 | Facility | None | $229.09 | $562.34 | $933.25 |
Blue Shield Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $1,445.44 | Professional | None | $426.58 | $794.33 | $1,445.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $316.23 | Professional | None | $165.96 | $186.21 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $165.96 Median $389.05 Typical High $426.58 | Professional | None | $165.96 | $389.05 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $707.95 | Professional | None | $234.42 | $354.81 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,187.76 | Professional | None | $2,137.96 | $2,137.96 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $95.50 Median $223.87 Typical High $389.05 | Facility | None | $95.50 | $223.87 | $389.05 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $208.93 | Facility | None | $190.55 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $489.78 | Professional | None | $138.04 | $173.78 | $489.78 |
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 $87.10 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Where California sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 21st of 51
$209
HI $525DC $155
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.