How much rates vary
Facilitymedian $398 · 10th to 90th $355 to $1,698Professionalmedian $437 · 10th to 90th $288 to $5,248
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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $1,230.27 Typical High $2,454.71 | Facility | None | $302.00 | $1,230.27 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $1,047.13 | Professional | None | $371.54 | $416.87 | $1,047.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | RR · Rental | $380.19 | $380.19 | $380.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | UE · Used equipment | $288.40 | $288.40 | $288.40 |
Blue Shield Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $1,778.28 | Facility | None | $436.52 | $1,071.52 | $1,778.28 |
Blue Shield Setting Professional Modifier None Typical Low $812.83 Median $1,548.82 Typical High $2,754.23 | Professional | None | $812.83 | $1,548.82 | $2,754.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $602.56 | Professional | None | $269.15 | $302.00 | $602.56 |
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 $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $269.15 Median $741.31 Typical High $812.83 | Professional | None | $269.15 | $741.31 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,318.26 | Professional | None | $446.68 | $602.56 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,248.07 | Professional | None | $3,715.35 | $3,715.35 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $208.93 Median $398.11 Typical High $741.31 | Facility | None | $208.93 | $398.11 | $741.31 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $933.25 | Professional | None | $302.00 | $380.19 | $933.25 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Where California sits
The same service costs 2.8 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· 24th of 51
$417
HI $794DE $288
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.