How much rates vary
Facilitymedian $525 · 10th to 90th $479 to $2,138Professionalmedian $537 · 10th to 90th $363 to $6,026
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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $1,778.28 Typical High $3,548.13 | Facility | None | $380.19 | $1,778.28 | $3,548.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,548.82 | Professional | None | $478.63 | $630.96 | $1,548.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | RR · Rental | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | UE · Used equipment | $363.08 | $363.08 | $363.08 |
Blue Shield Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,570.40 | Facility | None | $630.96 | $1,548.82 | $2,570.40 |
Blue Shield Setting Professional Modifier None Typical Low $1,174.90 Median $2,187.76 Typical High $3,981.07 | Professional | None | $1,174.90 | $2,187.76 | $3,981.07 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $851.14 | Professional | None | $398.11 | $436.52 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $398.11 Median $1,071.52 Typical High $1,174.90 | Professional | None | $398.11 | $1,071.52 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,862.09 | Professional | None | $645.65 | $758.58 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,025.60 | Professional | None | $5,128.61 | $5,128.61 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $263.03 Median $489.78 Typical High $1,071.52 | Facility | None | $263.03 | $489.78 | $1,071.52 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Facility | None | $478.63 | $524.81 | $524.81 |
United Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $1,348.96 | Professional | None | $371.54 | $478.63 | $1,348.96 |
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 $239.88 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Where California sits
The same service costs 3.2 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· 25th of 51
$525
HI $1,175DE $363
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.