How much rates vary
Facilitymedian $1,660 · 10th to 90th $1,413 to $6,310Professionalmedian $1,585 · 10th to 90th $1,122 to $18,197
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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $5,370.32 Typical High $10,471.29 | Facility | None | $1,122.02 | $5,370.32 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $4,466.84 | Professional | None | $1,479.11 | $1,905.46 | $4,466.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,445.44 Median $1,445.44 Typical High $1,479.11 | Professional | RR · Rental | $1,445.44 | $1,445.44 | $1,479.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | UE · Used equipment | $1,071.52 | $1,071.52 | $1,122.02 |
Blue Shield Setting Facility Modifier None Typical Low $1,905.46 Median $4,570.88 Typical High $7,762.47 | Facility | None | $1,905.46 | $4,570.88 | $7,762.47 |
Blue Shield Setting Professional Modifier None Typical Low $3,548.13 Median $6,606.93 Typical High $11,748.98 | Professional | None | $3,548.13 | $6,606.93 | $11,748.98 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,148.15 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,047.13 Median $3,235.94 Typical High $3,548.13 | Professional | None | $1,047.13 | $3,235.94 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $5,623.41 | Professional | None | $1,905.46 | $2,238.72 | $5,623.41 |
Lucent Health Setting Professional Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $18,197.01 | Professional | None | $15,488.17 | $15,488.17 | $18,197.01 |
Molina Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $776.25 Median $1,548.82 Typical High $3,235.94 | Facility | None | $776.25 | $1,548.82 | $3,235.94 |
Providence Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,584.89 | $1,659.59 | $1,659.59 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $3,981.07 | Professional | None | $1,122.02 | $1,412.54 | $3,981.07 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Where California sits
The same service costs 3.1 times more in Hawaii than in Delaware. 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· 20th of 51
$1,660
HI $3,467DE $1,122
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.