How much rates vary
Facilitymedian $1,549 · 10th to 90th $1,413 to $6,310Professionalmedian $1,738 · 10th to 90th $1,202 to $20,893
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,174.90 | $5,248.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $4,466.84 | Professional | None | $1,479.11 | $1,995.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | RR · Rental | $1,479.11 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,096.48 Median $1,096.48 Typical High $1,122.02 | Professional | UE · Used equipment | $1,096.48 | $1,096.48 | $1,122.02 |
Blue Shield Setting Facility Modifier None Typical Low $1,862.09 Median $4,570.88 Typical High $7,585.78 | Facility | None | $1,862.09 | $4,570.88 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $3,467.37 Median $6,456.54 Typical High $11,748.98 | Professional | None | $3,467.37 | $6,456.54 | $11,748.98 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,288.25 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,174.90 Median $3,162.28 Typical High $3,467.37 | Professional | None | $1,174.90 | $3,162.28 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $5,495.41 | Professional | None | $1,905.46 | $2,187.76 | $5,495.41 |
Lucent Health Setting Professional Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $20,892.96 | Professional | None | $15,848.93 | $15,848.93 | $20,892.96 |
Molina Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $812.83 Median $1,778.28 Typical High $3,162.28 | Facility | None | $812.83 | $1,778.28 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,412.54 | $1,548.82 | $1,548.82 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $3,981.07 | Professional | None | $1,148.15 | $1,548.82 | $3,981.07 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Where California sits
The same service costs 2.7 times more in Hawaii than in Maryland. 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· 23rd of 51
$1,738
HI $3,467MD $1,288
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.