How much rates vary
Facilitymedian $331 · 10th to 90th $282 to $1,380Professionalmedian $447 · 10th to 90th $282 to $4,786
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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $2,238.72 | Facility | None | $302.00 | $1,122.02 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $954.99 | Professional | None | $407.38 | $489.78 | $954.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | RR · Rental | $380.19 | $380.19 | $457.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $281.84 Typical High $346.74 | Professional | UE · Used equipment | $281.84 | $281.84 | $346.74 |
Blue Shield Setting Facility Modifier None Typical Low $398.11 Median $954.99 Typical High $1,621.81 | Facility | None | $398.11 | $954.99 | $1,621.81 |
Blue Shield Setting Professional Modifier None Typical Low $741.31 Median $1,380.38 Typical High $2,454.71 | Professional | None | $741.31 | $1,380.38 | $2,454.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $537.03 | Professional | None | $316.23 | $346.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Contra Costa Health Setting Professional Modifier None Typical Low $316.23 Median $676.08 Typical High $741.31 | Professional | None | $316.23 | $676.08 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $1,174.90 | Professional | None | $407.38 | $602.56 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,786.30 | Professional | None | $3,801.89 | $3,801.89 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $389.05 Typical High $676.08 | Facility | None | $208.93 | $389.05 | $676.08 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $331.13 | Facility | None | $281.84 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $831.76 | Professional | None | $295.12 | $380.19 | $831.76 |
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 $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Where California sits
The same service costs 2.6 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· 34th of 51
$398
HI $724DE $282
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.