How much rates vary
Facilitymedian $331 · 10th to 90th $295 to $1,413Professionalmedian $407 · 10th to 90th $295 to $6,607
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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $1,122.02 Typical High $2,238.72 | Facility | None | $309.03 | $1,122.02 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $977.24 | Professional | None | $338.84 | $512.86 | $977.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | RR · Rental | $371.54 | $389.05 | $389.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | UE · Used equipment | $281.84 | $295.12 | $295.12 |
Blue Shield Setting Facility Modifier None Typical Low $398.11 Median $977.24 Typical High $1,621.81 | Facility | None | $398.11 | $977.24 | $1,621.81 |
Blue Shield Setting Professional Modifier None Typical Low $741.31 Median $1,412.54 Typical High $2,511.89 | Professional | None | $741.31 | $1,412.54 | $2,511.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $549.54 | Professional | None | $138.04 | $154.88 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $138.04 Median $676.08 Typical High $758.58 | Professional | None | $138.04 | $676.08 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $1,202.26 | Professional | None | $407.38 | $616.60 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $6,606.93 | Professional | None | $4,365.16 | $4,365.16 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $213.80 Median $398.11 Typical High $676.08 | Facility | None | $213.80 | $398.11 | $676.08 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $295.12 Median $331.13 Typical High $331.13 | Facility | None | $295.12 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $851.14 | Professional | None | $302.00 | $389.05 | $851.14 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Where California sits
The same service costs 3.0 times more in Montana 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· 24th of 51
$398
MT $871FL $295
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.