How much rates vary
Facilitymedian $245 · 10th to 90th $191 to $813Professionalmedian $263 · 10th to 90th $182 to $3,890
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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $389.05 | Professional | None | $295.12 | $309.03 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $645.65 Typical High $1,288.25 | Facility | None | $181.97 | $645.65 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $549.54 | Professional | None | $229.09 | $302.00 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | RR · Rental | $234.42 | $234.42 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | UE · Used equipment | $173.78 | $173.78 | $173.78 |
Blue Shield Setting Facility Modifier None Typical Low $229.09 Median $562.34 Typical High $933.25 | Facility | None | $229.09 | $562.34 | $933.25 |
Blue Shield Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $1,445.44 | Professional | None | $426.58 | $794.33 | $1,445.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $309.03 | Professional | None | $97.72 | $109.65 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None | $181.97 | $181.97 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $97.72 Median $389.05 Typical High $426.58 | Professional | None | $97.72 | $389.05 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $707.95 | Professional | None | $234.42 | $346.74 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,570.40 | $2,570.40 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $125.89 Median $245.47 Typical High $389.05 | Facility | None | $125.89 | $245.47 | $389.05 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None | $181.97 | $181.97 | $245.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $190.55 Median $245.47 Typical High $245.47 | Facility | None | $190.55 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $489.78 | Professional | None | $181.97 | $229.09 | $489.78 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where California sits
The same service costs 2.5 times more in Kansas 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· 36th of 51
$245
KS $457FL $186
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.