How much rates vary
Facilitymedian $4,786 · 10th to 90th $2,455 to $13,490Professionalmedian $3,020 · 10th to 90th $1,995 to $30,903
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $7,943.28 Typical High $15,848.93 | Facility | None | $2,398.83 | $7,943.28 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $3,311.31 Typical High $6,918.31 | Professional | None | $3,019.95 | $3,311.31 | $6,918.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | RR · Rental | $3,019.95 | $3,019.95 | $3,019.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | UE · Used equipment | $2,290.87 | $2,290.87 | $2,290.87 |
Blue Shield Setting Facility Modifier None Typical Low $2,818.38 Median $6,918.31 Typical High $11,481.54 | Facility | None | $2,818.38 | $6,918.31 | $11,481.54 |
Blue Shield Setting Professional Modifier None Typical Low $5,248.07 Median $10,000.00 Typical High $17,782.79 | Professional | None | $5,248.07 | $10,000.00 | $17,782.79 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,235.94 Typical High $3,890.45 | Professional | None | $2,884.03 | $3,235.94 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,187.76 | $3,019.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,786.30 Typical High $5,248.07 | Professional | None | $2,884.03 | $4,786.30 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $8,511.38 | Professional | None | $2,884.03 | $3,388.44 | $8,511.38 |
Lucent Health Setting Professional Modifier None Typical Low $26,915.35 Median $26,915.35 Typical High $30,902.95 | Professional | None | $26,915.35 | $26,915.35 | $30,902.95 |
Molina Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Providence Setting Facility Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $4,786.30 | Facility | None | $2,884.03 | $3,019.95 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,187.76 | $3,019.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $5,370.32 | Facility | None | $4,570.88 | $4,570.88 | $5,370.32 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $6,025.60 | Professional | None | $1,862.09 | $2,454.71 | $6,025.60 |
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Where California sits
The same service costs 2.4 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· 26th of 51
$3,020
HI $5,248WV $2,188
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.