How much rates vary
Facilitymedian $141 · 10th to 90th $126 to $562Professionalmedian $151 · 10th to 90th $105 to $1,862
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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $478.63 Typical High $954.99 | Facility | None | $102.33 | $478.63 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $398.11 | Professional | None | $125.89 | $138.04 | $398.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | RR · Rental | $125.89 | $128.82 | $128.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | UE · Used equipment | $95.50 | $95.50 | $95.50 |
Blue Shield Setting Facility Modifier None Typical Low $169.82 Median $416.87 Typical High $691.83 | Facility | None | $169.82 | $416.87 | $691.83 |
Blue Shield Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $1,071.52 | Professional | None | $316.23 | $588.84 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $229.09 | Professional | None | $114.82 | $125.89 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $114.82 Median $288.40 Typical High $316.23 | Professional | None | $114.82 | $288.40 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $562.34 | Professional | None | $173.78 | $229.09 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,380.38 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $70.79 Median $165.96 Typical High $288.40 | Facility | None | $70.79 | $165.96 | $288.40 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $141.25 | Facility | None | $138.04 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $363.08 | Professional | None | $100.00 | $138.04 | $363.08 |
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 $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Where California sits
The same service costs 2.8 times more in Hawaii than in Florida. 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
$151
HI $331FL $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.