How much rates vary
Facilitymedian $245 · 10th to 90th $219 to $1,000Professionalmedian $282 · 10th to 90th $200 to $3,236
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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $831.76 Typical High $1,659.59 | Facility | None | $190.55 | $831.76 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $691.83 | Professional | None | $239.88 | $316.23 | $691.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | RR · Rental | $239.88 | $239.88 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
Blue Shield Setting Facility Modifier None Typical Low $295.12 Median $707.95 Typical High $1,202.26 | Facility | None | $295.12 | $707.95 | $1,202.26 |
Blue Shield Setting Professional Modifier None Typical Low $549.54 Median $1,023.29 Typical High $1,819.70 | Professional | None | $549.54 | $1,023.29 | $1,819.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $398.11 | Professional | None | $158.49 | $173.78 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $158.49 Median $501.19 Typical High $549.54 | Professional | None | $158.49 | $501.19 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $870.96 | Professional | None | $302.00 | $407.38 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,235.94 | Professional | None | $2,398.83 | $2,398.83 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $131.83 Median $309.03 Typical High $501.19 | Facility | None | $131.83 | $309.03 | $501.19 |
Providence Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $218.78 Median $245.47 Typical High $245.47 | Facility | None | $218.78 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $616.60 | Professional | None | $190.55 | $245.47 | $616.60 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $23.99 |
Where California sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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· 28th of 51
$282
HI $525PA $214
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.