How much rates vary
Facilitymedian $562 · 10th to 90th $479 to $2,138Professionalmedian $575 · 10th to 90th $363 to $7,413
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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,819.70 Typical High $3,630.78 | Facility | None | $389.05 | $1,819.70 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,548.82 | Professional | None | $489.78 | $645.65 | $1,548.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | RR · Rental | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | UE · Used equipment | $363.08 | $363.08 | $363.08 |
Blue Shield Setting Facility Modifier None Typical Low $645.65 Median $1,548.82 Typical High $2,630.27 | Facility | None | $645.65 | $1,548.82 | $2,630.27 |
Blue Shield Setting Professional Modifier None Typical Low $1,202.26 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,202.26 | $2,238.72 | $3,981.07 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $870.96 | Professional | None | $478.63 | $524.81 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $478.63 Median $1,096.48 Typical High $1,202.26 | Professional | None | $478.63 | $1,096.48 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,905.46 | Professional | None | $660.69 | $851.14 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $7,413.10 | Professional | None | $5,754.40 | $5,754.40 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $263.03 Median $501.19 Typical High $1,096.48 | Facility | None | $263.03 | $501.19 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $537.03 Median $562.34 Typical High $562.34 | Facility | None | $537.03 | $562.34 | $562.34 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,348.96 | Professional | None | $380.19 | $478.63 | $1,348.96 |
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 $239.88 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Where California sits
The same service costs 3.9 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· 21st of 51
$562
HI $1,413DE $363
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.