How much rates vary
Facilitymedian $302 · 10th to 90th $229 to $1,175Professionalmedian $295 · 10th to 90th $204 to $3,631
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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $870.96 Typical High $1,698.24 | Facility | None | $194.98 | $870.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $741.31 | Professional | None | $245.47 | $331.13 | $741.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | RR · Rental | $245.47 | $251.19 | $251.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | UE · Used equipment | $181.97 | $186.21 | $186.21 |
Blue Shield Setting Facility Modifier None Typical Low $309.03 Median $741.31 Typical High $1,258.93 | Facility | None | $309.03 | $741.31 | $1,258.93 |
Blue Shield Setting Professional Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,905.46 | Professional | None | $575.44 | $1,071.52 | $1,905.46 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $416.87 | Professional | None | $158.49 | $173.78 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $158.49 Median $512.86 Typical High $575.44 | Professional | None | $158.49 | $512.86 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $912.01 | Professional | None | $309.03 | $398.11 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,630.78 | Professional | None | $2,570.40 | $2,570.40 | $3,630.78 |
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 $134.90 Median $302.00 Typical High $512.86 | Facility | None | $134.90 | $302.00 | $512.86 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $645.65 | Professional | None | $194.98 | $251.19 | $645.65 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where California sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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· 22nd of 51
$302
HI $550PA $219
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.