How much rates vary
Facilitymedian $1,380 · 10th to 90th $776 to $5,623Professionalmedian $1,479 · 10th to 90th $1,047 to $15,849
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $4,677.35 Typical High $9,332.54 | Facility | None | $1,000.00 | $4,677.35 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,288.25 | $1,698.24 | $3,981.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | RR · Rental | $1,258.93 | $1,258.93 | $1,288.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | UE · Used equipment | $954.99 | $954.99 | $954.99 |
Blue Shield Setting Facility Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $6,760.83 | Facility | None | $1,659.59 | $4,073.80 | $6,760.83 |
Blue Shield Setting Professional Modifier None Typical Low $3,090.30 Median $5,888.44 Typical High $10,471.29 | Professional | None | $3,090.30 | $5,888.44 | $10,471.29 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $2,290.87 | Professional | None | $707.95 | $776.25 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,174.90 | $1,621.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $707.95 Median $2,818.38 Typical High $3,090.30 | Professional | None | $707.95 | $2,818.38 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $2,454.71 Typical High $5,011.87 | Professional | None | $1,698.24 | $2,454.71 | $5,011.87 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $15,848.93 | Professional | None | $14,125.38 | $14,125.38 | $15,848.93 |
Molina 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 |
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 $691.83 Median $1,621.81 Typical High $2,818.38 | Facility | None | $691.83 | $1,621.81 | $2,818.38 |
Providence Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,174.90 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,380.38 Typical High $1,380.38 | Facility | None | $776.25 | $1,380.38 | $1,380.38 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $3,548.13 | Professional | None | $1,000.00 | $1,380.38 | $3,548.13 |
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 $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
Where California sits
The same service costs 2.7 times more in Hawaii than in Pennsylvania. 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
$1,479
HI $3,020PA $1,122
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.