How much rates vary
Facilitymedian $195 · 10th to 90th $178 to $794Professionalmedian $195 · 10th to 90th $138 to $3,020
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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $660.69 Typical High $1,318.26 | Facility | None | $141.25 | $660.69 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $575.44 | Professional | None | $177.83 | $229.09 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | RR · Rental | $177.83 | $177.83 | $181.97 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | UE · Used equipment | $131.83 | $134.90 | $134.90 |
Blue Shield Setting Facility Modifier None Typical Low $234.42 Median $575.44 Typical High $954.99 | Facility | None | $234.42 | $575.44 | $954.99 |
Blue Shield Setting Professional Modifier None Typical Low $436.52 Median $831.76 Typical High $1,479.11 | Professional | None | $436.52 | $831.76 | $1,479.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $323.59 | Professional | None | $138.04 | $154.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $138.04 Median $398.11 Typical High $436.52 | Professional | None | $138.04 | $398.11 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $724.44 | Professional | None | $239.88 | $346.74 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,995.26 | $1,995.26 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $97.72 Median $190.55 Typical High $398.11 | Facility | None | $97.72 | $190.55 | $398.11 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
United Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $194.98 | Facility | None | $190.55 | $194.98 | $194.98 |
United Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $501.19 | Professional | None | $141.25 | $177.83 | $501.19 |
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 $89.13 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $17.78 |
Where California sits
The same service costs 3.5 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· 23rd of 51
$195
HI $479FL $138
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.