How much rates vary
Facilitymedian $525 · 10th to 90th $501 to $2,188Professionalmedian $603 · 10th to 90th $427 to $6,607
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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $1,778.28 Typical High $3,548.13 | Facility | None | $416.87 | $1,778.28 | $3,548.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $1,513.56 | Professional | None | $489.78 | $562.34 | $1,513.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | RR · Rental | $524.81 | $524.81 | $524.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | UE · Used equipment | $389.05 | $398.11 | $398.11 |
Blue Shield Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,630.27 | Facility | None | $630.96 | $1,548.82 | $2,630.27 |
Blue Shield Setting Professional Modifier None Typical Low $1,202.26 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,202.26 | $2,238.72 | $3,981.07 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $870.96 | Professional | None | $416.87 | $457.09 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $416.87 Median $1,071.52 Typical High $1,202.26 | Professional | None | $416.87 | $1,071.52 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,905.46 | Professional | None | $645.65 | $758.58 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,606.93 | Professional | None | $5,754.40 | $5,754.40 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $288.40 Median $588.84 Typical High $1,071.52 | Facility | None | $288.40 | $588.84 | $1,071.52 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $524.81 | Facility | None | $501.19 | $524.81 | $524.81 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $1,348.96 | Professional | None | $407.38 | $537.03 | $1,348.96 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Where California sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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· 27th of 51
$589
HI $1,175WV $427
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.