How much rates vary
Facilitymedian $347 · 10th to 90th $316 to $1,380Professionalmedian $372 · 10th to 90th $263 to $4,571
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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $1,174.90 Typical High $2,344.23 | Facility | None | $251.19 | $1,174.90 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $1,023.29 | Professional | None | $316.23 | $426.58 | $1,023.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | RR · Rental | $316.23 | $316.23 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | UE · Used equipment | $239.88 | $239.88 | $239.88 |
Blue Shield Setting Facility Modifier None Typical Low $416.87 Median $1,023.29 Typical High $1,698.24 | Facility | None | $416.87 | $1,023.29 | $1,698.24 |
Blue Shield Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $2,630.27 | Professional | None | $776.25 | $1,445.44 | $2,630.27 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $575.44 | Professional | None | $309.03 | $338.84 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $309.03 Median $707.95 Typical High $776.25 | Professional | None | $309.03 | $707.95 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,230.27 | Professional | None | $426.58 | $645.65 | $1,230.27 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,570.88 | Professional | None | $3,715.35 | $3,715.35 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $173.78 Median $371.54 Typical High $707.95 | Facility | None | $173.78 | $371.54 | $707.95 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $891.25 | Professional | None | $245.47 | $316.23 | $891.25 |
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 $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where California sits
The same service costs 4.5 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· 20th of 51
$372
HI $912KS $204
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.