How much rates vary
Facilitymedian $2,399 · 10th to 90th $2,188 to $10,000Professionalmedian $2,754 · 10th to 90th $1,995 to $30,200
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 $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $8,128.31 Typical High $16,218.10 | Facility | None | $1,905.46 | $8,128.31 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $6,918.31 | Professional | None | $2,398.83 | $2,570.40 | $6,918.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | RR · Rental | $2,398.83 | $2,398.83 | $2,398.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $1,819.70 Typical High $1,819.70 | Professional | UE · Used equipment | $1,778.28 | $1,819.70 | $1,819.70 |
Blue Shield Setting Facility Modifier None Typical Low $2,884.03 Median $7,079.46 Typical High $11,748.98 | Facility | None | $2,884.03 | $7,079.46 | $11,748.98 |
Blue Shield Setting Professional Modifier None Typical Low $5,370.32 Median $10,000.00 Typical High $18,197.01 | Professional | None | $5,370.32 | $10,000.00 | $18,197.01 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $3,890.45 | Professional | None | $1,412.54 | $1,548.82 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,995.26 | $1,995.26 | $2,754.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,412.54 Median $4,897.79 Typical High $5,370.32 | Professional | None | $1,412.54 | $4,897.79 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $8,511.38 | Professional | None | $2,951.21 | $3,715.35 | $8,511.38 |
Lucent Health Setting Professional Modifier None Typical Low $24,547.09 Median $24,547.09 Typical High $30,199.52 | Professional | None | $24,547.09 | $24,547.09 | $30,199.52 |
Molina Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $1,318.26 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,318.26 | $2,754.23 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,995.26 | $1,995.26 | $2,754.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,187.76 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $6,165.95 | Professional | None | $1,905.46 | $2,398.83 | $6,165.95 |
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
Where California sits
The same service costs 2.6 times more in Hawaii than in West Virginia. 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· 22nd of 51
$2,754
HI $5,129WV $1,995
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.