How much rates vary
Facilitymedian $224 · 10th to 90th $166 to $955Professionalmedian $309 · 10th to 90th $219 to $3,631
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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $758.58 Typical High $1,513.56 | Facility | None | $208.93 | $758.58 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $660.69 | Professional | None | $269.15 | $346.74 | $660.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | RR · Rental | $263.03 | $263.03 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | UE · Used equipment | $199.53 | $199.53 | $199.53 |
Blue Shield Setting Facility Modifier None Typical Low $269.15 Median $660.69 Typical High $1,096.48 | Facility | None | $269.15 | $660.69 | $1,096.48 |
Blue Shield Setting Professional Modifier None Typical Low $501.19 Median $954.99 Typical High $1,698.24 | Professional | None | $501.19 | $954.99 | $1,698.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $371.54 | Professional | None | $138.04 | $151.36 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $138.04 Median $457.09 Typical High $501.19 | Professional | None | $138.04 | $457.09 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $891.25 | Professional | None | $275.42 | $416.87 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,951.21 | $2,951.21 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $144.54 Median $363.08 Typical High $457.09 | Facility | None | $144.54 | $363.08 | $457.09 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $223.87 | Facility | None | $165.96 | $223.87 | $223.87 |
United Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $575.44 | Professional | None | $208.93 | $263.03 | $575.44 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where California sits
The same service costs 2.2 times more in Wisconsin 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· 26th of 51
$309
WI $550PA $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.