How much rates vary
Facilitymedian $263 · 10th to 90th $229 to $1,202Professionalmedian $288 · 10th to 90th $191 to $3,090
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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $891.25 Typical High $1,778.28 | Facility | None | $194.98 | $891.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $741.31 | Professional | None | $323.59 | $346.74 | $741.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | RR · Rental | $245.47 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | UE · Used equipment | $181.97 | $181.97 | $239.88 |
Blue Shield Setting Facility Modifier None Typical Low $316.23 Median $758.58 Typical High $1,288.25 | Facility | None | $316.23 | $758.58 | $1,288.25 |
Blue Shield Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,949.84 | Professional | None | $588.84 | $1,096.48 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $426.58 | Professional | None | $194.98 | $213.80 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | None | $190.55 | $190.55 | $263.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $194.98 Median $537.03 Typical High $588.84 | Professional | None | $194.98 | $537.03 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $933.25 | Professional | None | $323.59 | $426.58 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,090.30 | Professional | None | $2,754.23 | $2,754.23 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $134.90 Median $263.03 Typical High $537.03 | Facility | None | $134.90 | $263.03 | $537.03 |
Providence Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | None | $190.55 | $190.55 | $263.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $660.69 | Professional | None | $190.55 | $269.15 | $660.69 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $23.99 |
Where California sits
The same service costs 3.0 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· 30th of 51
$288
HI $562DE $191
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.