How much rates vary
Facilitymedian $380 · 10th to 90th $339 to $1,413Professionalmedian $427 · 10th to 90th $302 to $6,166
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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $1,148.15 Typical High $2,290.87 | Facility | None | $288.40 | $1,148.15 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $977.24 | Professional | None | $371.54 | $489.78 | $977.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | RR · Rental | $371.54 | $371.54 | $371.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | UE · Used equipment | $275.42 | $275.42 | $275.42 |
Blue Shield Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $1,659.59 | Facility | None | $407.38 | $1,000.00 | $1,659.59 |
Blue Shield Setting Professional Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,570.40 | Professional | None | $758.58 | $1,412.54 | $2,570.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $549.54 | Professional | None | $208.93 | $229.09 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $208.93 Median $691.83 Typical High $758.58 | Professional | None | $208.93 | $691.83 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $1,202.26 | Professional | None | $416.87 | $602.56 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $6,165.95 | Professional | None | $4,073.80 | $4,073.80 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $199.53 Median $426.58 Typical High $691.83 | Facility | None | $199.53 | $426.58 | $691.83 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $380.19 | Facility | None | $338.84 | $380.19 | $380.19 |
United Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $870.96 | Professional | None | $288.40 | $363.08 | $870.96 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Where California sits
The same service costs 2.7 times more in Hawaii 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· 24th of 51
$427
HI $759KS $282
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.