How much rates vary
Facilitymedian $646 · 10th to 90th $427 to $2,239Professionalmedian $537 · 10th to 90th $372 to $5,754
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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $1,659.59 Typical High $3,235.94 | Facility | None | $363.08 | $1,659.59 | $3,235.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,380.38 | Professional | None | $457.09 | $616.60 | $1,380.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | RR · Rental | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | UE · Used equipment | $346.74 | $346.74 | $346.74 |
Blue Shield Setting Facility Modifier None Typical Low $588.84 Median $1,412.54 Typical High $2,398.83 | Facility | None | $588.84 | $1,412.54 | $2,398.83 |
Blue Shield Setting Professional Modifier None Typical Low $1,096.48 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,096.48 | $2,041.74 | $3,630.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $794.33 | Professional | None | $416.87 | $457.09 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $416.87 Median $977.24 Typical High $1,096.48 | Professional | None | $416.87 | $977.24 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,737.80 | Professional | None | $588.84 | $707.95 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Professional | None | $4,786.30 | $4,786.30 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $251.19 Median $645.65 Typical High $977.24 | Facility | None | $251.19 | $645.65 | $977.24 |
Providence Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $1,230.27 | Professional | None | $354.81 | $489.78 | $1,230.27 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Where California sits
The same service costs 2.7 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· 21st of 51
$562
HI $1,096DC $407
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.