How much rates vary
Facilitymedian $1,318 · 10th to 90th $1,122 to $5,012Professionalmedian $1,288 · 10th to 90th $933 to $19,055
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $4,265.80 Typical High $8,511.38 | Facility | None | $912.01 | $4,265.80 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $3,548.13 | Professional | None | $1,071.52 | $1,230.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | RR · Rental | $1,148.15 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | UE · Used equipment | $851.14 | $851.14 | $851.14 |
Blue Shield Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $6,165.95 | Facility | None | $1,513.56 | $3,715.35 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $2,818.38 Median $5,248.07 Typical High $9,332.54 | Professional | None | $2,818.38 | $5,248.07 | $9,332.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,122.02 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $2,818.38 | Professional | None | $1,023.29 | $2,570.40 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $4,466.84 | Professional | None | $1,548.82 | $2,238.72 | $4,466.84 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $19,054.61 | Professional | None | $12,302.69 | $12,302.69 | $19,054.61 |
Molina Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $630.96 Median $1,288.25 Typical High $2,570.40 | Facility | None | $630.96 | $1,288.25 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,258.93 | $1,318.26 | $1,318.26 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $3,235.94 | Professional | None | $891.25 | $1,122.02 | $3,235.94 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Where California sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 23rd of 51
$1,318
HI $3,020AL $933
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.