How much rates vary
Facilitymedian $1,660 · 10th to 90th $1,288 to $7,079Professionalmedian $2,188 · 10th to 90th $1,549 to $23,442
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 $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $5,623.41 Typical High $11,220.18 | Facility | None | $1,479.11 | $5,623.41 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $4,786.30 | Professional | None | $1,862.09 | $2,454.71 | $4,786.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | RR · Rental | $1,862.09 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | UE · Used equipment | $1,412.54 | $1,412.54 | $1,412.54 |
Blue Shield Setting Facility Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $8,128.31 | Facility | None | $1,995.26 | $4,897.79 | $8,128.31 |
Blue Shield Setting Professional Modifier None Typical Low $3,715.35 Median $6,918.31 Typical High $12,589.25 | Professional | None | $3,715.35 | $6,918.31 | $12,589.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,380.38 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,862.09 | $2,570.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $3,715.35 | Professional | None | $1,258.93 | $3,388.44 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $5,888.44 | Professional | None | $2,041.74 | $2,884.03 | $5,888.44 |
Lucent Health Setting Professional Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $23,442.29 | Professional | None | $17,782.79 | $17,782.79 | $23,442.29 |
Molina Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $1,023.29 Median $2,570.40 Typical High $3,388.44 | Facility | None | $1,023.29 | $2,570.40 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,862.09 | $2,570.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,288.25 | $1,659.59 | $1,659.59 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $4,265.80 | Professional | None | $1,445.44 | $1,862.09 | $4,265.80 |
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 $912.01 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Where California sits
The same service costs 2.4 times more in Wisconsin 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· 24th of 51
$2,188
WI $3,981DC $1,660
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.