How much rates vary
Facilitymedian $174 · 10th to 90th $126 to $708Professionalmedian $209 · 10th to 90th $138 to $2,344
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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $588.84 Typical High $1,148.15 | Facility | None | $144.54 | $588.84 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $501.19 | Professional | None | $177.83 | $239.88 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | RR · Rental | $186.21 | $186.21 | $186.21 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | UE · Used equipment | $138.04 | $138.04 | $138.04 |
Blue Shield Setting Facility Modifier None Typical Low $208.93 Median $501.19 Typical High $851.14 | Facility | None | $208.93 | $501.19 | $851.14 |
Blue Shield Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $1,288.25 | Professional | None | $389.05 | $724.44 | $1,288.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $281.84 | Professional | None | $131.83 | $144.54 | $281.84 |
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 $131.83 Median $346.74 Typical High $389.05 | Professional | None | $131.83 | $346.74 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $630.96 | Professional | None | $208.93 | $302.00 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $100.00 Median $190.55 Typical High $346.74 | Facility | None | $100.00 | $190.55 | $346.74 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $173.78 | Facility | None | $125.89 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $436.52 | Professional | None | $144.54 | $181.97 | $436.52 |
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 $91.20 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Where California sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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· 29th of 51
$191
HI $372DE $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.