How much rates vary
Facilitymedian $158 · 10th to 90th $132 to $589Professionalmedian $155 · 10th to 90th $102 to $1,660
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $489.78 Typical High $977.24 | Facility | None | $104.71 | $489.78 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $416.87 | Professional | None | $131.83 | $177.83 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | RR · Rental | $131.83 | $131.83 | $134.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | UE · Used equipment | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Facility Modifier None Typical Low $173.78 Median $426.58 Typical High $707.95 | Facility | None | $173.78 | $426.58 | $707.95 |
Blue Shield Setting Professional Modifier None Typical Low $323.59 Median $602.56 Typical High $1,096.48 | Professional | None | $323.59 | $602.56 | $1,096.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $234.42 | Professional | None | $104.71 | $114.82 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $104.71 Median $295.12 Typical High $323.59 | Professional | None | $104.71 | $295.12 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $575.44 | Professional | None | $177.83 | $251.19 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,548.82 | $1,548.82 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $72.44 Median $141.25 Typical High $295.12 | Facility | None | $72.44 | $141.25 | $295.12 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
United Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Facility | None | $144.54 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $371.54 | Professional | None | $102.33 | $144.54 | $371.54 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.18 |
Where California sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 25th of 51
$155
HI $380FL $102
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.