How much rates vary
Facilitymedian $1,349 · 10th to 90th $794 to $3,548Professionalmedian $794 · 10th to 90th $603 to $13,183
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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $5,888.44 | Facility | None | $630.96 | $2,951.21 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $2,570.40 | Professional | None | $691.83 | $1,023.29 | $2,570.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | RR · Rental | $794.33 | $794.33 | $812.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | UE · Used equipment | $588.84 | $602.56 | $602.56 |
Blue Shield Setting Facility Modifier None Typical Low $1,047.13 Median $2,570.40 Typical High $4,265.80 | Facility | None | $1,047.13 | $2,570.40 | $4,265.80 |
Blue Shield Setting Professional Modifier None Typical Low $1,949.84 Median $3,715.35 Typical High $6,606.93 | Professional | None | $1,949.84 | $3,715.35 | $6,606.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,445.44 | Professional | None | $933.25 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Contra Costa Health Setting Professional Modifier None Typical Low $933.25 Median $1,778.28 Typical High $1,949.84 | Professional | None | $933.25 | $1,778.28 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,071.52 | $1,621.81 | $3,162.28 |
Lucent Health Setting Professional Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $13,182.57 | Professional | None | $13,182.57 | $13,182.57 | $13,182.57 |
Molina 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 |
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 $436.52 Median $831.76 Typical High $1,778.28 | Facility | None | $436.52 | $831.76 | $1,778.28 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $870.96 | $1,348.96 | $1,348.96 |
United Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $2,238.72 | Professional | None | $630.96 | $794.33 | $2,238.72 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Where California sits
The same service costs 5.4 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· 21st of 51
$871
HI $3,236DE $603
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.