How much rates vary
Facilitymedian $288 · 10th to 90th $263 to $1,175Professionalmedian $302 · 10th to 90th $200 to $3,311
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 $977.24 Typical High $1,949.84 | Facility | None | $208.93 | $977.24 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $831.76 | Professional | None | $245.47 | $281.84 | $831.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | RR · Rental | $263.03 | $263.03 | $263.03 |
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 $346.74 Median $851.14 Typical High $1,412.54 | Facility | None | $346.74 | $851.14 | $1,412.54 |
Blue Shield Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,187.76 | Professional | None | $645.65 | $1,202.26 | $2,187.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $478.63 | Professional | None | $204.17 | $223.87 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $204.17 Median $588.84 Typical High $645.65 | Professional | None | $204.17 | $588.84 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $1,023.29 | Professional | None | $354.81 | $537.03 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,311.31 | Professional | None | $2,884.03 | $2,884.03 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $269.15 Typical High $588.84 | Facility | None | $144.54 | $269.15 | $588.84 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $288.40 | Facility | None | $281.84 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $741.31 | Professional | None | $204.17 | $288.40 | $741.31 |
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 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· 28th of 51
$288
HI $661DE $200
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.