How much rates vary
Facilitymedian $575 · 10th to 90th $389 to $1,738Professionalmedian $468 · 10th to 90th $295 to $5,248
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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $1,479.11 Typical High $2,951.21 | Facility | None | $316.23 | $1,479.11 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $1,258.93 | Professional | None | $354.81 | $512.86 | $1,258.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | RR · Rental | $380.19 | $398.11 | $398.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | UE · Used equipment | $288.40 | $295.12 | $295.12 |
Blue Shield Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $2,137.96 | Facility | None | $524.81 | $1,288.25 | $2,137.96 |
Blue Shield Setting Professional Modifier None Typical Low $977.24 Median $1,819.70 Typical High $3,311.31 | Professional | None | $977.24 | $1,819.70 | $3,311.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $707.95 | Professional | None | $426.58 | $467.74 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $977.24 | Professional | None | $426.58 | $891.25 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,548.82 | Professional | None | $537.03 | $794.33 | $1,548.82 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,248.07 | Professional | None | $5,128.61 | $5,128.61 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $218.78 Median $407.38 Typical High $891.25 | Facility | None | $218.78 | $407.38 | $891.25 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
United Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $575.44 | Facility | None | $436.52 | $575.44 | $575.44 |
United Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $1,122.02 | Professional | None | $309.03 | $389.05 | $1,122.02 |
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 $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Where California sits
The same service costs 4.3 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· 19th of 51
$468
HI $1,259DE $295
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.