How much rates vary
Facilitymedian $372 · 10th to 90th $269 to $1,479Professionalmedian $398 · 10th to 90th $275 to $4,266
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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $1,258.93 Typical High $2,511.89 | Facility | None | $269.15 | $1,258.93 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,071.52 | Professional | None | $323.59 | $446.68 | $1,071.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | RR · Rental | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | UE · Used equipment | $257.04 | $257.04 | $257.04 |
Blue Shield Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $1,819.70 | Facility | None | $446.68 | $1,096.48 | $1,819.70 |
Blue Shield Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $2,818.38 | Professional | None | $831.76 | $1,548.82 | $2,818.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $602.56 | Professional | None | $323.59 | $354.81 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $323.59 Median $758.58 Typical High $831.76 | Professional | None | $323.59 | $758.58 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $1,318.26 | Professional | None | $457.09 | $602.56 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,265.80 | Professional | None | $3,801.89 | $3,801.89 | $4,265.80 |
Molina Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $186.21 Median $371.54 Typical High $758.58 | Facility | None | $186.21 | $371.54 | $758.58 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
United Setting Facility Modifier None Typical Low $269.15 Median $371.54 Typical High $371.54 | Facility | None | $269.15 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $954.99 | Professional | None | $263.03 | $338.84 | $954.99 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where California sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$372
HI $813VT $275
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.