How much rates vary
Facilitymedian $1,479 · 10th to 90th $1,072 to $4,677Professionalmedian $1,175 · 10th to 90th $871 to $14,125
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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $3,981.07 Typical High $7,943.28 | Facility | None | $851.14 | $3,981.07 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,479.11 | $3,388.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | RR · Rental | $1,071.52 | $1,071.52 | $1,174.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $812.83 Median $812.83 Typical High $851.14 | Professional | UE · Used equipment | $812.83 | $812.83 | $851.14 |
Blue Shield Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $5,754.40 | Facility | None | $1,412.54 | $3,467.37 | $5,754.40 |
Blue Shield Setting Professional Modifier None Typical Low $2,630.27 Median $4,897.79 Typical High $8,912.51 | Professional | None | $2,630.27 | $4,897.79 | $8,912.51 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,348.96 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,398.83 Typical High $2,630.27 | Professional | None | $1,230.27 | $2,398.83 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,445.44 | $2,089.30 | $4,168.69 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,125.38 | Professional | None | $14,125.38 | $14,125.38 | $14,125.38 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $588.84 Median $1,174.90 Typical High $2,398.83 | Facility | None | $588.84 | $1,174.90 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,174.90 | $1,479.11 | $1,479.11 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $3,019.95 | Professional | None | $831.76 | $1,071.52 | $3,019.95 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Where California sits
The same service costs 4.0 times more in Hawaii than in Pennsylvania. 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
$1,175
HI $3,467PA $871
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.