How much rates vary
Facilitymedian $871 · 10th to 90th $832 to $3,548Professionalmedian $891 · 10th to 90th $646 to $12,023
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 $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,884.03 Typical High $5,754.40 | Facility | None | $660.69 | $2,884.03 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $2,454.71 | Professional | None | $831.76 | $891.25 | $2,454.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | RR · Rental | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | UE · Used equipment | $616.60 | $630.96 | $630.96 |
Blue Shield Setting Facility Modifier None Typical Low $1,023.29 Median $2,511.89 Typical High $4,168.69 | Facility | None | $1,023.29 | $2,511.89 | $4,168.69 |
Blue Shield Setting Professional Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $6,456.54 | Professional | None | $1,905.46 | $3,548.13 | $6,456.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $1,380.38 | Professional | None | $416.87 | $457.09 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $416.87 Median $1,737.80 Typical High $1,905.46 | Professional | None | $416.87 | $1,737.80 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,513.56 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $12,022.64 | Professional | None | $8,317.64 | $8,317.64 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $457.09 Median $891.25 Typical High $1,737.80 | Facility | None | $457.09 | $891.25 | $1,737.80 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
United Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $870.96 | Facility | None | $851.14 | $870.96 | $870.96 |
United Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $2,187.76 | Professional | None | $645.65 | $831.76 | $2,187.76 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Where California sits
The same service costs 3.0 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· 25th of 51
$891
HI $1,905DE $646
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.