How much rates vary
Facilitymedian $186 · 10th to 90th $158 to $708Professionalmedian $178 · 10th to 90th $129 to $1,905
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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | None | $158.49 | $158.49 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $602.56 Typical High $1,202.26 | Facility | None | $128.82 | $602.56 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $512.86 | Professional | None | $125.89 | $213.80 | $512.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | RR · Rental | $128.82 | $162.18 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | UE · Used equipment | $93.33 | $120.23 | $120.23 |
Blue Shield Setting Facility Modifier None Typical Low $213.80 Median $524.81 Typical High $870.96 | Facility | None | $213.80 | $524.81 | $870.96 |
Blue Shield Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $1,348.96 | Professional | None | $398.11 | $741.31 | $1,348.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $288.40 | Professional | None | $131.83 | $144.54 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Facility | None | $177.83 | $177.83 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $131.83 Median $363.08 Typical High $398.11 | Professional | None | $131.83 | $363.08 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $645.65 | Professional | None | $218.78 | $309.03 | $645.65 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,041.74 | Professional | None | $1,905.46 | $1,905.46 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $89.13 Median $177.83 Typical High $363.08 | Facility | None | $89.13 | $177.83 | $363.08 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $676.08 | Professional | None | $50.12 | $50.12 | $676.08 |
United Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $186.21 | Facility | None | $177.83 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $457.09 | Professional | None | $125.89 | $158.49 | $457.09 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where California sits
The same service costs 3.5 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· 28th of 51
$178
HI $457DE $129
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.