How much rates vary
Facilitymedian $251 · 10th to 90th $186 to $891Professionalmedian $282 · 10th to 90th $191 to $2,951
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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | None | $229.09 | $229.09 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $416.87 | Professional | None | $323.59 | $323.59 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $776.25 Typical High $1,548.82 | Facility | None | $223.87 | $776.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $660.69 | Professional | None | $275.42 | $302.00 | $660.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | RR · Rental | $281.84 | $281.84 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | UE · Used equipment | $208.93 | $213.80 | $213.80 |
Blue Shield Setting Facility Modifier None Typical Low $275.42 Median $676.08 Typical High $1,122.02 | Facility | None | $275.42 | $676.08 | $1,122.02 |
Blue Shield Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $1,737.80 | Professional | None | $512.86 | $954.99 | $1,737.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $371.54 | Professional | None | $245.47 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $302.00 | Facility | None | $295.12 | $295.12 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Contra Costa Health Setting Professional Modifier None Typical Low $245.47 Median $467.74 Typical High $512.86 | Professional | None | $245.47 | $467.74 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $831.76 | Professional | None | $302.00 | $416.87 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,238.72 | $2,238.72 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $125.89 Median $295.12 Typical High $467.74 | Facility | None | $125.89 | $295.12 | $467.74 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $588.84 | Professional | None | $177.83 | $229.09 | $588.84 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where California sits
The same service costs 2.5 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· 31st of 51
$269
HI $513DC $209
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.