How much rates vary
Facilitymedian $309 · 10th to 90th $135 to $617Professionalmedian $135 · 10th to 90th $102 to $3,467
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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $512.86 Typical High $1,023.29 | Facility | None | $109.65 | $512.86 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $436.52 | Professional | None | $131.83 | $169.82 | $436.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | RR · Rental | $134.90 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | UE · Used equipment | $100.00 | $102.33 | $102.33 |
Blue Shield Setting Facility Modifier None Typical Low $181.97 Median $436.52 Typical High $741.31 | Facility | None | $181.97 | $436.52 | $741.31 |
Blue Shield Setting Professional Modifier None Typical Low $338.84 Median $630.96 Typical High $1,122.02 | Professional | None | $338.84 | $630.96 | $1,122.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $245.47 | Professional | None | $162.18 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $338.84 | Professional | None | $162.18 | $309.03 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $602.56 | Professional | None | $186.21 | $275.42 | $602.56 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $74.13 Median $141.25 Typical High $309.03 | Facility | None | $74.13 | $141.25 | $309.03 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $151.36 Median $263.03 Typical High $389.05 | Facility | None | $151.36 | $263.03 | $389.05 |
United Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $380.19 | Professional | None | $107.15 | $134.90 | $380.19 |
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 $67.61 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
Where California sits
The same service costs 8.1 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
$151
HI $832DE $102
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.