How much rates vary
Facilitymedian $257 · 10th to 90th $214 to $1,047Professionalmedian $316 · 10th to 90th $219 to $3,388
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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $870.96 Typical High $1,737.80 | Facility | None | $213.80 | $870.96 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $741.31 | Professional | None | $269.15 | $354.81 | $741.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | RR · Rental | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | UE · Used equipment | $199.53 | $199.53 | $204.17 |
Blue Shield Setting Facility Modifier None Typical Low $309.03 Median $758.58 Typical High $1,258.93 | Facility | None | $309.03 | $758.58 | $1,258.93 |
Blue Shield Setting Professional Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,949.84 | Professional | None | $575.44 | $1,071.52 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $416.87 | Professional | None | $204.17 | $223.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $204.17 Median $524.81 Typical High $575.44 | Professional | None | $204.17 | $524.81 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $912.01 | Professional | None | $316.23 | $407.38 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,388.44 | Professional | None | $2,630.27 | $2,630.27 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $144.54 Median $316.23 Typical High $524.81 | Facility | None | $144.54 | $316.23 | $524.81 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
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 $213.80 Median $257.04 Typical High $257.04 | Facility | None | $213.80 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $660.69 | Professional | None | $208.93 | $263.03 | $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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where California sits
The same service costs 2.5 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· 25th of 51
$316
HI $562DE $229
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.