How much rates vary
Facilitymedian $1,622 · 10th to 90th $1,445 to $6,607Professionalmedian $1,950 · 10th to 90th $1,259 to $23,442
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $5,495.41 Typical High $10,964.78 | Facility | None | $1,348.96 | $5,495.41 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $4,570.88 | Professional | None | $1,698.24 | $1,819.70 | $4,570.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | RR · Rental | $1,698.24 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | UE · Used equipment | $1,258.93 | $1,258.93 | $1,258.93 |
Blue Shield Setting Facility Modifier None Typical Low $1,949.84 Median $4,677.35 Typical High $7,943.28 | Facility | None | $1,949.84 | $4,677.35 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $3,630.78 Median $6,760.83 Typical High $12,022.64 | Professional | None | $3,630.78 | $6,760.83 | $12,022.64 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,122.02 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $3,630.78 | Professional | None | $1,023.29 | $3,311.31 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $5,754.40 | Professional | None | $1,995.26 | $2,454.71 | $5,754.40 |
Lucent Health Setting Professional Modifier None Typical Low $17,378.01 Median $17,378.01 Typical High $23,442.29 | Professional | None | $17,378.01 | $17,378.01 | $23,442.29 |
Molina Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $933.25 Median $1,737.80 Typical High $3,311.31 | Facility | None | $933.25 | $1,737.80 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,445.44 | $1,621.81 | $1,621.81 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $4,073.80 | Professional | None | $1,318.26 | $1,659.59 | $4,073.80 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Where California sits
The same service costs 2.7 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· 31st of 51
$1,738
HI $3,388DE $1,259
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.