How much rates vary
Facilitymedian $407 · 10th to 90th $363 to $708Professionalmedian $562 · 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 $478.63 | Professional | None | $446.68 | $446.68 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $1,778.28 | Facility | None | $331.13 | $426.58 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,174.90 | Professional | None | $457.09 | $588.84 | $1,174.90 |
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 $338.84 Median $338.84 Typical High $338.84 | Professional | UE · Used equipment | $338.84 | $338.84 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $912.01 Median $1,698.24 Typical High $3,090.30 | Professional | None | $912.01 | $1,698.24 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,000.00 | Professional | None | $660.69 | $912.01 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,621.81 | Professional | None | $524.81 | $758.58 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,754.40 | Professional | None | $5,128.61 | $5,128.61 | $5,754.40 |
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 $660.69 Typical High $831.76 | Facility | None | $251.19 | $660.69 | $831.76 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $1,047.13 | Professional | None | $354.81 | $446.68 | $1,047.13 |
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 $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
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 2.5 times more in Montana 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· 24th of 51
$562
MT $1,047DC $417
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.