How much rates vary
Facilitymedian $380 · 10th to 90th $229 to $1,000Professionalmedian $229 · 10th to 90th $174 to $3,981
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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $851.14 Typical High $1,698.24 | Facility | None | $181.97 | $851.14 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $724.44 | Professional | None | $213.80 | $239.88 | $724.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | RR · Rental | $223.87 | $229.09 | $229.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | UE · Used equipment | $165.96 | $173.78 | $173.78 |
Blue Shield Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $1,230.27 | Facility | None | $302.00 | $741.31 | $1,230.27 |
Blue Shield Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,905.46 | Professional | None | $562.34 | $1,047.13 | $1,905.46 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $407.38 | Professional | None | $165.96 | $181.97 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $165.96 Median $512.86 Typical High $562.34 | Professional | None | $165.96 | $512.86 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $891.25 | Professional | None | $309.03 | $436.52 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $125.89 Median $234.42 Typical High $512.86 | Facility | None | $125.89 | $234.42 | $512.86 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $380.19 | Facility | None | $251.19 | $380.19 | $380.19 |
United Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $645.65 | Professional | None | $177.83 | $229.09 | $645.65 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where California sits
The same service costs 5.5 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· 24th of 51
$245
HI $955FL $174
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.