How much rates vary
Facilitymedian $282 · 10th to 90th $209 to $933Professionalmedian $224 · 10th to 90th $174 to $2,692
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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $794.33 Typical High $1,584.89 | Facility | None | $169.82 | $794.33 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $660.69 | Professional | None | $218.78 | $281.84 | $660.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | RR · Rental | $213.80 | $213.80 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | UE · Used equipment | $158.49 | $158.49 | $162.18 |
Blue Shield Setting Facility Modifier None Typical Low $281.84 Median $676.08 Typical High $1,148.15 | Facility | None | $281.84 | $676.08 | $1,148.15 |
Blue Shield Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $1,737.80 | Professional | None | $524.81 | $977.24 | $1,737.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $380.19 | Professional | None | $177.83 | $194.98 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $177.83 Median $478.63 Typical High $524.81 | Professional | None | $177.83 | $478.63 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $831.76 | Professional | None | $288.40 | $426.58 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $117.49 Median $245.47 Typical High $478.63 | Facility | None | $117.49 | $245.47 | $478.63 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $281.84 | Facility | None | $234.42 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $588.84 | Professional | None | $165.96 | $234.42 | $588.84 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Where California sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 23rd of 51
$245
HI $646TN $178
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.