How much rates vary
Facilitymedian $891 · 10th to 90th $794 to $3,548Professionalmedian $955 · 10th to 90th $603 to $13,490
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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Ambetter 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 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $6,025.60 | Facility | None | $645.65 | $3,019.95 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,570.40 | Professional | None | $812.83 | $1,047.13 | $2,570.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | RR · Rental | $812.83 | $812.83 | $812.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | UE · Used equipment | $602.56 | $602.56 | $602.56 |
Blue Shield Setting Facility Modifier None Typical Low $1,071.52 Median $2,630.27 Typical High $4,365.16 | Facility | None | $1,071.52 | $2,630.27 | $4,365.16 |
Blue Shield Setting Professional Modifier None Typical Low $1,995.26 Median $3,715.35 Typical High $6,606.93 | Professional | None | $1,995.26 | $3,715.35 | $6,606.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,445.44 | Professional | None | $812.83 | $912.01 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Contra Costa Health Setting Professional Modifier None Typical Low $812.83 Median $1,819.70 Typical High $1,995.26 | Professional | None | $812.83 | $1,819.70 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,096.48 | $1,621.81 | $3,162.28 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $13,489.63 | Professional | None | $9,332.54 | $9,332.54 | $13,489.63 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $446.68 Median $831.76 Typical High $1,819.70 | Facility | None | $446.68 | $831.76 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $870.96 Median $891.25 Typical High $891.25 | Facility | None | $870.96 | $891.25 | $891.25 |
United Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $2,290.87 | Professional | None | $630.96 | $794.33 | $2,290.87 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Where California sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$891
HI $2,239KS $513
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.