How much rates vary
Facilitymedian $204 · 10th to 90th $182 to $794Professionalmedian $214 · 10th to 90th $151 to $2,884
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 $676.08 Typical High $1,348.96 | Facility | None | $144.54 | $676.08 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $588.84 | Professional | None | $181.97 | $239.88 | $588.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | RR · Rental | $181.97 | $181.97 | $181.97 |
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 $239.88 Median $588.84 Typical High $977.24 | Facility | None | $239.88 | $588.84 | $977.24 |
Blue Shield Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $1,513.56 | Professional | None | $446.68 | $831.76 | $1,513.56 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $331.13 | Professional | None | $147.91 | $162.18 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $147.91 Median $407.38 Typical High $446.68 | Professional | None | $147.91 | $407.38 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $741.31 | Professional | None | $245.47 | $371.54 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,187.76 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $218.78 Typical High $407.38 | Facility | None | $100.00 | $218.78 | $407.38 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $204.17 | Facility | None | $199.53 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $512.86 | Professional | None | $144.54 | $181.97 | $512.86 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $26.92 |
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 3.3 times more in Hawaii than in West Virginia. 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· 20th of 51
$214
HI $525WV $158
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.