How much rates vary
Facilitymedian $692 · 10th to 90th $479 to $2,754Professionalmedian $676 · 10th to 90th $513 to $7,079
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 $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $776.25 | Professional | None | $616.60 | $616.60 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | None | $707.95 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $2,344.23 Typical High $4,570.88 | Facility | None | $489.78 | $2,344.23 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,995.26 | Professional | None | $602.56 | $812.83 | $1,995.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | RR · Rental | $616.60 | $630.96 | $630.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | UE · Used equipment | $457.09 | $467.74 | $467.74 |
Blue Shield Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $3,388.44 | Facility | None | $831.76 | $1,995.26 | $3,388.44 |
Blue Shield Setting Professional Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $5,128.61 | Professional | None | $1,548.82 | $2,884.03 | $5,128.61 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $1,122.02 | Professional | None | $660.69 | $724.44 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $724.44 | Facility | None | $707.95 | $707.95 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $660.69 Median $1,412.54 Typical High $1,548.82 | Professional | None | $660.69 | $1,412.54 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,454.71 | Professional | None | $831.76 | $1,230.27 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $10,471.29 | Professional | None | $7,079.46 | $7,079.46 | $10,471.29 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $346.74 Median $707.95 Typical High $1,412.54 | Facility | None | $346.74 | $707.95 | $1,412.54 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $478.63 Median $691.83 Typical High $691.83 | Facility | None | $478.63 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,737.80 | Professional | None | $489.78 | $616.60 | $1,737.80 |
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 $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Where California sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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· 28th of 51
$692
HI $1,738MS $513
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.