How much rates vary
Facilitymedian $324 · 10th to 90th $240 to $1,288Professionalmedian $355 · 10th to 90th $240 to $4,898
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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $1,096.48 Typical High $2,137.96 | Facility | None | $229.09 | $1,096.48 | $2,137.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $933.25 | Professional | None | $295.12 | $389.05 | $933.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | RR · Rental | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | UE · Used equipment | $218.78 | $218.78 | $218.78 |
Blue Shield Setting Facility Modifier None Typical Low $389.05 Median $933.25 Typical High $1,584.89 | Facility | None | $389.05 | $933.25 | $1,584.89 |
Blue Shield Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $2,398.83 | Professional | None | $724.44 | $1,348.96 | $2,398.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $524.81 | Professional | None | $223.87 | $245.47 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $223.87 Median $660.69 Typical High $724.44 | Professional | None | $223.87 | $660.69 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $1,288.25 | Professional | None | $389.05 | $588.84 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,897.79 | Professional | None | $3,162.28 | $3,162.28 | $4,897.79 |
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 $158.49 Median $363.08 Typical High $660.69 | Facility | None | $158.49 | $363.08 | $660.69 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $239.88 Median $323.59 Typical High $323.59 | Facility | None | $239.88 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $812.83 | Professional | None | $229.09 | $323.59 | $812.83 |
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 $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $28.84 |
Where California sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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· 24th of 51
$347
HI $708AL $269
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.