How much rates vary
Facilitymedian $251 · 10th to 90th $204 to $912Professionalmedian $224 · 10th to 90th $166 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 $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 $204.17 Typical High $257.04 | Professional | None | $204.17 | $204.17 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $371.54 | Professional | None | $234.42 | $275.42 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $776.25 Typical High $1,513.56 | Facility | None | $162.18 | $776.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $645.65 | Professional | None | $204.17 | $275.42 | $645.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | RR · Rental | $208.93 | $208.93 | $213.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | UE · Used equipment | $154.88 | $154.88 | $154.88 |
Blue Shield Setting Facility Modifier None Typical Low $275.42 Median $660.69 Typical High $1,122.02 | Facility | None | $275.42 | $660.69 | $1,122.02 |
Blue Shield Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $1,698.24 | Professional | None | $512.86 | $954.99 | $1,698.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $371.54 | Professional | None | $245.47 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $245.47 Median $467.74 Typical High $512.86 | Professional | None | $245.47 | $467.74 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $831.76 | Professional | None | $275.42 | $398.11 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,454.71 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $229.09 Typical High $467.74 | Facility | None | $112.20 | $229.09 | $467.74 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Facility | None | $229.09 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $575.44 | Professional | None | $162.18 | $204.17 | $575.44 |
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 $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
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 3.5 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· 26th of 51
$229
HI $589DE $166
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.