How much rates vary
Facilitymedian $347 · 10th to 90th $257 to $1,479Professionalmedian $457 · 10th to 90th $316 to $5,370
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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $1,174.90 Typical High $2,344.23 | Facility | None | $331.13 | $1,174.90 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $1,000.00 | Professional | None | $389.05 | $457.09 | $1,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | RR · Rental | $416.87 | $416.87 | $416.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | UE · Used equipment | $316.23 | $316.23 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $416.87 Median $1,023.29 Typical High $1,698.24 | Facility | None | $416.87 | $1,023.29 | $1,698.24 |
Blue Shield Setting Professional Modifier None Typical Low $776.25 Median $1,479.11 Typical High $2,630.27 | Professional | None | $776.25 | $1,479.11 | $2,630.27 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $575.44 | Professional | None | $263.03 | $295.12 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Contra Costa Health Setting Professional Modifier None Typical Low $263.03 Median $707.95 Typical High $794.33 | Professional | None | $263.03 | $707.95 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,258.93 | Professional | None | $426.58 | $645.65 | $1,258.93 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,370.32 | Professional | None | $4,677.35 | $4,677.35 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $229.09 Median $436.52 Typical High $707.95 | Facility | None | $229.09 | $436.52 | $707.95 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $346.74 | Facility | None | $257.04 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $891.25 | Professional | None | $331.13 | $416.87 | $891.25 |
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 $208.93 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $41.69 |
Where California sits
The same service costs 2.8 times more in Montana 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· 30th of 51
$437
MT $891FL $316
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.