How much rates vary
Facilitymedian $912 · 10th to 90th $708 to $3,162Professionalmedian $851 · 10th to 90th $537 to $11,220
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 $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $2,691.53 Typical High $5,248.07 | Facility | None | $562.34 | $2,691.53 | $5,248.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $2,290.87 | Professional | None | $707.95 | $933.25 | $2,290.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | RR · Rental | $724.44 | $724.44 | $741.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | UE · Used equipment | $537.03 | $537.03 | $537.03 |
Blue Shield Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $3,890.45 | Facility | None | $954.99 | $2,290.87 | $3,890.45 |
Blue Shield Setting Professional Modifier None Typical Low $1,778.28 Median $3,311.31 Typical High $5,888.44 | Professional | None | $1,778.28 | $3,311.31 | $5,888.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,288.25 | Professional | None | $851.14 | $933.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $1,778.28 | Professional | None | $851.14 | $1,584.89 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,818.38 | Professional | None | $954.99 | $1,348.96 | $2,818.38 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $11,220.18 | Professional | None | $10,232.93 | $10,232.93 | $11,220.18 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $389.05 Median $741.31 Typical High $1,584.89 | Facility | None | $389.05 | $741.31 | $1,584.89 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $912.01 | Facility | None | $776.25 | $912.01 | $912.01 |
United Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,995.26 | Professional | None | $562.34 | $707.95 | $1,995.26 |
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 $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
Where California sits
The same service costs 4.6 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· 24th of 51
$851
HI $2,455DE $537
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.