How much rates vary
Facilitymedian $676 · 10th to 90th $295 to $1,862Professionalmedian $417 · 10th to 90th $302 to $5,012
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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | None | $363.08 | $363.08 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $1,122.02 Typical High $2,238.72 | Facility | None | $288.40 | $1,122.02 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $954.99 | Professional | None | $398.11 | $478.63 | $954.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $371.54 Median $371.54 Typical High $407.38 | Professional | RR · Rental | $371.54 | $371.54 | $407.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | UE · Used equipment | $275.42 | $275.42 | $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 $1,380.38 Typical High $2,511.89 | Professional | None | $741.31 | $1,380.38 | $2,511.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $537.03 | Professional | None | $354.81 | $389.05 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $354.81 Median $676.08 Typical High $741.31 | Professional | None | $354.81 | $676.08 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $1,174.90 | Professional | None | $407.38 | $602.56 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $5,011.87 | Professional | None | $3,467.37 | $3,467.37 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $199.53 Median $416.87 Typical High $676.08 | Facility | None | $199.53 | $416.87 | $676.08 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
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 $707.95 Median $707.95 Typical High $831.76 | Facility | None | $707.95 | $707.95 | $831.76 |
United Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $851.14 | Professional | None | $288.40 | $363.08 | $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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Where California sits
The same service costs 2.2 times more in Montana 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· 23rd of 51
$417
MT $692DE $309
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.