How much rates vary
Facilitymedian $398 · 10th to 90th $355 to $1,585Professionalmedian $427 · 10th to 90th $295 to $4,571
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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $1,348.96 Typical High $2,630.27 | Facility | None | $281.84 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $1,148.15 | Professional | None | $363.08 | $478.63 | $1,148.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | RR · Rental | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | UE · Used equipment | $269.15 | $269.15 | $269.15 |
Blue Shield Setting Facility Modifier None Typical Low $478.63 Median $1,148.15 Typical High $1,949.84 | Facility | None | $478.63 | $1,148.15 | $1,949.84 |
Blue Shield Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,951.21 | Professional | None | $891.25 | $1,659.59 | $2,951.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $645.65 | Professional | None | $371.54 | $407.38 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $371.54 Median $812.83 Typical High $891.25 | Professional | None | $371.54 | $812.83 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,412.54 | Professional | None | $478.63 | $707.95 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,570.88 | Professional | None | $4,466.84 | $4,466.84 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $194.98 Median $398.11 Typical High $812.83 | Facility | None | $194.98 | $398.11 | $812.83 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $1,000.00 | Professional | None | $281.84 | $398.11 | $1,000.00 |
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 $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Where California sits
The same service costs 3.7 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· 26th of 51
$398
HI $1,096DE $295
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.