How much rates vary
Facilitymedian $550 · 10th to 90th $479 to $2,188Professionalmedian $550 · 10th to 90th $372 to $7,244
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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,862.09 Typical High $3,630.78 | Facility | None | $389.05 | $1,862.09 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,584.89 | Professional | None | $478.63 | $660.69 | $1,584.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | RR · Rental | $489.78 | $501.19 | $501.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | UE · Used equipment | $363.08 | $371.54 | $371.54 |
Blue Shield Setting Facility Modifier None Typical Low $660.69 Median $1,584.89 Typical High $2,691.53 | Facility | None | $660.69 | $1,584.89 | $2,691.53 |
Blue Shield Setting Professional Modifier None Typical Low $1,230.27 Median $2,290.87 Typical High $4,073.80 | Professional | None | $1,230.27 | $2,290.87 | $4,073.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $891.25 | Professional | None | $398.11 | $436.52 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $398.11 Median $1,122.02 Typical High $1,230.27 | Professional | None | $398.11 | $1,122.02 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,949.84 | Professional | None | $660.69 | $954.99 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $7,244.36 | Professional | None | $5,370.32 | $5,370.32 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $269.15 Median $512.86 Typical High $1,122.02 | Facility | None | $269.15 | $512.86 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
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 $478.63 Median $549.54 Typical High $549.54 | Facility | None | $478.63 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $1,380.38 | Professional | None | $389.05 | $489.78 | $1,380.38 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Where California sits
The same service costs 3.2 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· 22nd of 51
$550
HI $1,202DE $372
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.