How much rates vary
Facilitymedian $380 · 10th to 90th $166 to $1,047Professionalmedian $229 · 10th to 90th $155 to $1,950
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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $323.59 | Professional | None | $204.17 | $213.80 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $338.84 | Professional | None | $263.03 | $281.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $630.96 Typical High $1,230.27 | Facility | None | $162.18 | $630.96 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $537.03 | Professional | None | $223.87 | $269.15 | $537.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | RR · Rental | $204.17 | $204.17 | $223.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | UE · Used equipment | $154.88 | $154.88 | $165.96 |
Blue Shield Setting Facility Modifier None Typical Low $223.87 Median $537.03 Typical High $912.01 | Facility | None | $223.87 | $537.03 | $912.01 |
Blue Shield Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,380.38 | Professional | None | $416.87 | $776.25 | $1,380.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | None | $229.09 | $251.19 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $416.87 | Professional | None | $229.09 | $380.19 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $676.08 | Professional | None | $223.87 | $263.03 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,949.84 | $1,949.84 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $112.20 Median $208.93 Typical High $380.19 | Facility | None | $112.20 | $208.93 | $380.19 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
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 $389.05 Median $389.05 Typical High $457.09 | Facility | None | $389.05 | $389.05 | $457.09 |
United Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $467.74 | Professional | None | $162.18 | $204.17 | $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 $102.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Where California sits
The same service costs 2.4 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· 22nd of 51
$234
HI $380DE $158
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.