How much rates vary
Facilitymedian $170 · 10th to 90th $141 to $676Professionalmedian $178 · 10th to 90th $117 to $1,950
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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $575.44 Typical High $1,148.15 | Facility | None | $123.03 | $575.44 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $489.78 | Professional | None | $154.88 | $213.80 | $489.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | RR · Rental | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Blue Shield Setting Facility Modifier None Typical Low $204.17 Median $501.19 Typical High $831.76 | Facility | None | $204.17 | $501.19 | $831.76 |
Blue Shield Setting Professional Modifier None Typical Low $380.19 Median $707.95 Typical High $1,288.25 | Professional | None | $380.19 | $707.95 | $1,288.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $275.42 | Professional | None | $147.91 | $162.18 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $380.19 | Professional | None | $147.91 | $346.74 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $630.96 | Professional | None | $208.93 | $316.23 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,905.46 | $1,905.46 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $85.11 Median $158.49 Typical High $346.74 | Facility | None | $85.11 | $158.49 | $346.74 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $169.82 | Facility | None | $141.25 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $436.52 | Professional | None | $120.23 | $154.88 | $436.52 |
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 $77.62 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $15.49 |
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· 23rd of 51
$170
HI $468KS $107
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.