How much rates vary
Facilitymedian $174 · 10th to 90th $135 to $603Professionalmedian $166 · 10th to 90th $110 to $2,291
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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $501.19 Typical High $1,000.00 | Facility | None | $107.15 | $501.19 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $426.58 | Professional | None | $134.90 | $173.78 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | RR · Rental | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | UE · Used equipment | $102.33 | $102.33 | $102.33 |
Blue Shield Setting Facility Modifier None Typical Low $177.83 Median $436.52 Typical High $724.44 | Facility | None | $177.83 | $436.52 | $724.44 |
Blue Shield Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $1,122.02 | Professional | None | $331.13 | $616.60 | $1,122.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $239.88 | Professional | None | $75.86 | $83.18 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | None | $131.83 | $131.83 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $302.00 Typical High $331.13 | Professional | None | $75.86 | $302.00 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $588.84 | Professional | None | $181.97 | $269.15 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,737.80 | $1,737.80 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $74.13 Median $181.97 Typical High $302.00 | Facility | None | $74.13 | $181.97 | $302.00 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | None | $131.83 | $131.83 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $173.78 | Facility | None | $147.91 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $380.19 | Professional | None | $104.71 | $147.91 | $380.19 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
Where California sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 19th of 51
$174
HI $427DC $120
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.