How much rates vary
Facilitymedian $389 · 10th to 90th $257 to $1,148Professionalmedian $309 · 10th to 90th $204 to $3,467
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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $269.15 Median $346.74 Typical High $812.83 | Professional | None | $269.15 | $346.74 | $812.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | RR · Rental | $263.03 | $263.03 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | UE · Used equipment | $194.98 | $194.98 | $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 $223.87 Median $245.47 Typical High $467.74 | Professional | None | $223.87 | $245.47 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $223.87 Median $588.84 Typical High $645.65 | Professional | None | $223.87 | $588.84 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $1,023.29 | Professional | None | $354.81 | $524.81 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $281.84 Typical High $588.84 | Facility | None | $144.54 | $281.84 | $588.84 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
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 $288.40 Median $389.05 Typical High $389.05 | Facility | None | $288.40 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $741.31 | Professional | None | $204.17 | $281.84 | $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 $128.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $51.29 | $51.29 | $51.29 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Where California sits
The same service costs 4.1 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· 22nd of 51
$309
HI $832DE $204
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.