How much rates vary
Facilitymedian $275 · 10th to 90th $214 to $1,096Professionalmedian $269 · 10th to 90th $195 to $3,802
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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $309.03 | Professional | None | $245.47 | $245.47 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $363.08 | Professional | None | $263.03 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $933.25 Typical High $1,862.09 | Facility | None | $199.53 | $933.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $794.33 | Professional | None | $245.47 | $316.23 | $794.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | RR · Rental | $251.19 | $251.19 | $251.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | UE · Used equipment | $186.21 | $186.21 | $186.21 |
Blue Shield Setting Facility Modifier None Typical Low $331.13 Median $794.33 Typical High $1,348.96 | Facility | None | $331.13 | $794.33 | $1,348.96 |
Blue Shield Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $2,041.74 | Professional | None | $616.60 | $1,148.15 | $2,041.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $446.68 | Professional | None | $295.12 | $323.59 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $616.60 | Professional | None | $295.12 | $562.34 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $977.24 | Professional | None | $338.84 | $489.78 | $977.24 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,168.69 | Professional | None | $3,801.89 | $3,801.89 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $138.04 Median $263.03 Typical High $562.34 | Facility | None | $138.04 | $263.03 | $562.34 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $275.42 | Facility | None | $213.80 | $275.42 | $275.42 |
United Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $691.83 | Professional | None | $194.98 | $245.47 | $691.83 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where California sits
The same service costs 4.7 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
$269
HI $912DE $195
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.