How much rates vary
Facilitymedian $251 · 10th to 90th $174 to $1,072Professionalmedian $355 · 10th to 90th $251 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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $851.14 Typical High $1,698.24 | Facility | None | $239.88 | $851.14 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $724.44 | Professional | None | $302.00 | $398.11 | $724.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | RR · Rental | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | UE · Used equipment | $229.09 | $229.09 | $229.09 |
Blue Shield Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $1,230.27 | Facility | None | $302.00 | $741.31 | $1,230.27 |
Blue Shield Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,905.46 | Professional | None | $562.34 | $1,047.13 | $1,905.46 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $407.38 | Professional | None | $204.17 | $223.87 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $204.17 Median $512.86 Typical High $562.34 | Professional | None | $204.17 | $512.86 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $891.25 | Professional | None | $309.03 | $446.68 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,801.89 | Professional | None | $3,388.44 | $3,388.44 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $165.96 Median $346.74 Typical High $512.86 | Facility | None | $165.96 | $346.74 | $512.86 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $251.19 | Facility | None | $173.78 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $645.65 | Professional | None | $239.88 | $302.00 | $645.65 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Where California sits
The same service costs 2.9 times more in Iowa than in Kansas. 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
$347
IA $603KS $209
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.