How much rates vary
Facilitymedian $407 · 10th to 90th $324 to $1,413Professionalmedian $324 · 10th to 90th $245 to $4,266
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 $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $1,202.26 Typical High $2,398.83 | Facility | None | $257.04 | $1,202.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $1,047.13 | Professional | None | $316.23 | $426.58 | $1,047.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | RR · Rental | $323.59 | $323.59 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $245.47 Typical High $245.47 | Professional | UE · Used equipment | $239.88 | $245.47 | $245.47 |
Blue Shield Setting Facility Modifier None Typical Low $426.58 Median $1,047.13 Typical High $1,737.80 | Facility | None | $426.58 | $1,047.13 | $1,737.80 |
Blue Shield Setting Professional Modifier None Typical Low $794.33 Median $1,513.56 Typical High $2,691.53 | Professional | None | $794.33 | $1,513.56 | $2,691.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $588.84 | Professional | None | $251.19 | $275.42 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $251.19 Median $724.44 Typical High $794.33 | Professional | None | $251.19 | $724.44 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,288.25 | Professional | None | $436.52 | $660.69 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Molina Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $177.83 Median $338.84 Typical High $724.44 | Facility | None | $177.83 | $338.84 | $724.44 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $354.81 Median $407.38 Typical High $407.38 | Facility | None | $354.81 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $912.01 | Professional | None | $257.04 | $323.59 | $912.01 |
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 $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
Where California sits
The same service costs 4.2 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· 23rd of 51
$355
HI $1,023DE $245
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.