How much rates vary
Facilitymedian $363 · 10th to 90th $263 to $1,122Professionalmedian $347 · 10th to 90th $245 to $3,981
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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $891.25 Typical High $1,778.28 | Facility | None | $251.19 | $891.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $741.31 | Professional | None | $295.12 | $346.74 | $741.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | RR · Rental | $316.23 | $316.23 | $316.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | UE · Used equipment | $239.88 | $239.88 | $239.88 |
Blue Shield Setting Facility Modifier None Typical Low $316.23 Median $758.58 Typical High $1,288.25 | Facility | None | $316.23 | $758.58 | $1,288.25 |
Blue Shield Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,949.84 | Professional | None | $588.84 | $1,096.48 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $426.58 | Professional | None | $81.28 | $89.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $81.28 Median $537.03 Typical High $588.84 | Professional | None | $81.28 | $537.03 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $933.25 | Professional | None | $323.59 | $478.63 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,981.07 | Professional | None | $3,548.13 | $3,548.13 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $173.78 Median $338.84 Typical High $537.03 | Facility | None | $173.78 | $338.84 | $537.03 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $263.03 Median $363.08 Typical High $363.08 | Facility | None | $263.03 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $676.08 | Professional | None | $251.19 | $316.23 | $676.08 |
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 $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where California sits
The same service costs 2.8 times more in Wyoming than in Delaware. 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· 23rd of 51
$363
WY $676DE $245
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.