How much rates vary
Facilitymedian $389 · 10th to 90th $355 to $1,549Professionalmedian $427 · 10th to 90th $288 to $5,370
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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $1,318.26 Typical High $2,630.27 | Facility | None | $281.84 | $1,318.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $1,122.02 | Professional | None | $354.81 | $467.74 | $1,122.02 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | UE · Used equipment | $269.15 | $269.15 | $269.15 |
Blue Shield Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $1,905.46 | Facility | None | $467.74 | $1,148.15 | $1,905.46 |
Blue Shield Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $2,951.21 | Professional | None | $870.96 | $1,621.81 | $2,951.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $630.96 | Professional | None | $331.13 | $363.08 | $630.96 |
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 $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $331.13 Median $794.33 Typical High $870.96 | Professional | None | $331.13 | $794.33 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,380.38 | Professional | None | $478.63 | $630.96 | $1,380.38 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,370.32 | Professional | None | $3,981.07 | $3,981.07 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $194.98 Median $501.19 Typical High $794.33 | Facility | None | $194.98 | $501.19 | $794.33 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $1,000.00 | Professional | None | $275.42 | $389.05 | $1,000.00 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
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 $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Where California sits
The same service costs 3.0 times more in Hawaii than in Washington, DC. 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
$417
HI $933DC $316
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.