How much rates vary
Facilitymedian $288 · 10th to 90th $229 to $1,230Professionalmedian $417 · 10th to 90th $288 to $4,571
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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $977.24 Typical High $1,949.84 | Facility | None | $275.42 | $977.24 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $851.14 | Professional | None | $354.81 | $467.74 | $851.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | RR · Rental | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | UE · Used equipment | $263.03 | $263.03 | $263.03 |
Blue Shield Setting Facility Modifier None Typical Low $346.74 Median $851.14 Typical High $1,412.54 | Facility | None | $346.74 | $851.14 | $1,412.54 |
Blue Shield Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,187.76 | Professional | None | $645.65 | $1,202.26 | $2,187.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $478.63 | Professional | None | $173.78 | $190.55 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $173.78 Median $588.84 Typical High $645.65 | Professional | None | $173.78 | $588.84 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $1,148.15 | Professional | None | $354.81 | $537.03 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,570.88 | Professional | None | $3,630.78 | $3,630.78 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $190.55 Median $501.19 Typical High $588.84 | Facility | None | $190.55 | $501.19 | $588.84 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $288.40 | Facility | None | $229.09 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $741.31 | Professional | None | $275.42 | $346.74 | $741.31 |
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 $173.78 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $34.67 |
Where California sits
The same service costs 2.3 times more in Wisconsin than in Florida. 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
$417
WI $776FL $339
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.