How much rates vary
Facilitymedian $1,047 · 10th to 90th $933 to $4,365Professionalmedian $1,259 · 10th to 90th $871 to $13,490
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $3,548.13 Typical High $7,079.46 | Facility | None | $831.76 | $3,548.13 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,412.54 | $3,090.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | RR · Rental | $1,071.52 | $1,071.52 | $1,071.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | UE · Used equipment | $794.33 | $794.33 | $794.33 |
Blue Shield Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $5,128.61 | Facility | None | $1,258.93 | $3,090.30 | $5,128.61 |
Blue Shield Setting Professional Modifier None Typical Low $2,344.23 Median $4,466.84 Typical High $7,943.28 | Professional | None | $2,344.23 | $4,466.84 | $7,943.28 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,737.80 | Professional | None | $794.33 | $870.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,000.00 | $1,380.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $794.33 Median $2,137.96 Typical High $2,344.23 | Professional | None | $794.33 | $2,137.96 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,288.25 | $1,905.46 | $3,801.89 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $13,489.63 | Professional | None | $10,232.93 | $10,232.93 | $13,489.63 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $575.44 Median $1,380.38 Typical High $2,137.96 | Facility | None | $575.44 | $1,380.38 | $2,137.96 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,000.00 | $1,380.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Facility | None | $933.25 | $1,047.13 | $1,047.13 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $2,691.53 | Professional | None | $831.76 | $1,071.52 | $2,691.53 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Where California sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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
$1,259
HI $2,291DC $933
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.