How much rates vary
Facilitymedian $219 · 10th to 90th $182 to $871Professionalmedian $234 · 10th to 90th $148 to $2,570
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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $741.31 Typical High $1,445.44 | Facility | None | $154.88 | $741.31 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $616.60 | Professional | None | $194.98 | $263.03 | $616.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | RR · Rental | $199.53 | $199.53 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | UE · Used equipment | $147.91 | $147.91 | $147.91 |
Blue Shield Setting Facility Modifier None Typical Low $263.03 Median $630.96 Typical High $1,071.52 | Facility | None | $263.03 | $630.96 | $1,071.52 |
Blue Shield Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $1,621.81 | Professional | None | $489.78 | $912.01 | $1,621.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $354.81 | Professional | None | $117.49 | $128.82 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Contra Costa Health Setting Professional Modifier None Typical Low $117.49 Median $446.68 Typical High $489.78 | Professional | None | $117.49 | $446.68 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $794.33 | Professional | None | $263.03 | $354.81 | $794.33 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,187.76 | $2,570.40 |
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 $107.15 Median $204.17 Typical High $446.68 | Facility | None | $107.15 | $204.17 | $446.68 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Sutter Health Plus Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $218.78 | Facility | None | $181.97 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $549.54 | Professional | None | $154.88 | $218.78 | $549.54 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where California sits
The same service costs 3.3 times more in Hawaii 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· 27th of 51
$219
HI $501DE $151
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.