How much rates vary
Facilitymedian $1,380 · 10th to 90th $1,259 to $5,495Professionalmedian $1,445 · 10th to 90th $955 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 $1,258.93 Median $1,380.38 Typical High $3,890.45 | Professional | None | $1,258.93 | $1,380.38 | $3,890.45 |
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 $5,754.40 Typical High $10,471.29 | Professional | None | $3,090.30 | $5,754.40 | $10,471.29 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,202.26 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $3,090.30 | Professional | None | $1,096.48 | $2,818.38 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,897.79 | Professional | None | $1,698.24 | $2,089.30 | $4,897.79 |
Lucent Health Setting Professional Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $15,848.93 | Professional | None | $13,489.63 | $13,489.63 | $15,848.93 |
Molina 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 |
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 $1,288.25 Typical High $2,818.38 | Facility | None | $691.83 | $1,288.25 | $2,818.38 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
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 $1,348.96 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,348.96 | $1,380.38 | $1,380.38 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $3,548.13 | Professional | None | $977.24 | $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 $616.60 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
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 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· 24th of 51
$1,380
HI $3,236DE $955
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.