How much rates vary
Facilitymedian $3,090 · 10th to 90th $2,754 to $12,303Professionalmedian $3,236 · 10th to 90th $2,089 to $34,674
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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $10,232.93 Typical High $20,417.38 | Facility | None | $2,187.76 | $10,232.93 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $8,709.64 | Professional | None | $2,754.23 | $3,019.95 | $8,709.64 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | RR · Rental | $2,754.23 | $2,754.23 | $2,754.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | UE · Used equipment | $2,089.30 | $2,089.30 | $2,089.30 |
Blue Shield Setting Facility Modifier None Typical Low $3,630.78 Median $8,912.51 Typical High $14,791.08 | Facility | None | $3,630.78 | $8,912.51 | $14,791.08 |
Blue Shield Setting Professional Modifier None Typical Low $6,760.83 Median $12,882.50 Typical High $22,908.68 | Professional | None | $6,760.83 | $12,882.50 | $22,908.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $5,011.87 | Professional | None | $2,398.83 | $2,630.27 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,089.30 | $2,884.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,398.83 Median $6,165.95 Typical High $6,760.83 | Professional | None | $2,398.83 | $6,165.95 | $6,760.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,715.35 Median $4,466.84 Typical High $10,964.78 | Professional | None | $3,715.35 | $4,466.84 | $10,964.78 |
Lucent Health Setting Professional Modifier None Typical Low $30,902.95 Median $30,902.95 Typical High $34,673.69 | Professional | None | $30,902.95 | $30,902.95 | $34,673.69 |
Molina Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
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 $1,513.56 Median $2,884.03 Typical High $6,165.95 | Facility | None | $1,513.56 | $2,884.03 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,089.30 | $2,884.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,019.95 | $3,090.30 | $3,090.30 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $7,762.47 | Professional | None | $2,187.76 | $3,019.95 | $7,762.47 |
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $275.42 |
Where California sits
The same service costs 3.4 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· 25th of 51
$3,090
HI $7,079DE $2,089
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.