How much rates vary
Facilitymedian $214 · 10th to 90th $138 to $617Professionalmedian $138 · 10th to 90th $115 to $2,188
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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $524.81 Typical High $1,047.13 | Facility | None | $112.20 | $524.81 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $446.68 | Professional | None | $134.90 | $186.21 | $446.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | RR · Rental | $138.04 | $141.25 | $141.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | UE · Used equipment | $102.33 | $104.71 | $104.71 |
Blue Shield Setting Facility Modifier None Typical Low $186.21 Median $446.68 Typical High $758.58 | Facility | None | $186.21 | $446.68 | $758.58 |
Blue Shield Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $1,148.15 | Professional | None | $346.74 | $645.65 | $1,148.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $251.19 | Professional | None | $123.03 | $134.90 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $123.03 Median $316.23 Typical High $346.74 | Professional | None | $123.03 | $316.23 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $616.60 | Professional | None | $190.55 | $281.84 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $77.62 Median $165.96 Typical High $316.23 | Facility | None | $77.62 | $165.96 | $316.23 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $213.80 | Facility | None | $154.88 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $389.05 | Professional | None | $109.65 | $138.04 | $389.05 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where California sits
The same service costs 4.4 times more in Hawaii than in Florida. 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· 26th of 51
$155
HI $525FL $120
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.