How much rates vary
Facilitymedian $229 · 10th to 90th $166 to $741Professionalmedian $195 · 10th to 90th $126 to $2,455
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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $616.60 Typical High $1,230.27 | Facility | None | $131.83 | $616.60 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $524.81 | Professional | None | $144.54 | $213.80 | $524.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | RR · Rental | $162.18 | $165.96 | $165.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | UE · Used equipment | $123.03 | $125.89 | $125.89 |
Blue Shield Setting Facility Modifier None Typical Low $218.78 Median $537.03 Typical High $891.25 | Facility | None | $218.78 | $537.03 | $891.25 |
Blue Shield Setting Professional Modifier None Typical Low $407.38 Median $758.58 Typical High $1,380.38 | Professional | None | $407.38 | $758.58 | $1,380.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $295.12 | Professional | None | $194.98 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $407.38 | Professional | None | $194.98 | $371.54 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $676.08 | Professional | None | $223.87 | $323.59 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,454.71 | Professional | None | $2,398.83 | $2,398.83 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $91.20 Median $169.82 Typical High $371.54 | Facility | None | $91.20 | $169.82 | $371.54 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $229.09 | Facility | None | $181.97 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $467.74 | Professional | None | $128.82 | $165.96 | $467.74 |
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 $81.28 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $16.60 |
Where California sits
The same service costs 4.7 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· 20th of 51
$195
HI $589DE $126
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.