How much rates vary
Facilitymedian $263 · 10th to 90th $229 to $427Professionalmedian $355 · 10th to 90th $234 to $3,981
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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $269.15 Typical High $1,122.02 | Facility | None | $208.93 | $269.15 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $758.58 | Professional | None | $239.88 | $371.54 | $758.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | RR · Rental | $288.40 | $288.40 | $288.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | UE · Used equipment | $213.80 | $213.80 | $213.80 |
Blue Shield Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,995.26 | Professional | None | $588.84 | $1,096.48 | $1,995.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $426.58 | Professional | None | $281.84 | $309.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $588.84 | Professional | None | $281.84 | $537.03 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $933.25 | Professional | None | $323.59 | $380.19 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,981.07 | Professional | None | $2,691.53 | $2,691.53 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $158.49 Median $416.87 Typical High $537.03 | Facility | None | $158.49 | $416.87 | $537.03 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $676.08 | Professional | None | $223.87 | $281.84 | $676.08 |
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 $141.25 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Where California sits
The same service costs 2.5 times more in Montana than in New York. 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· 32nd of 51
$355
MT $550NY $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.