How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,738 to $7,586Professionalmedian $2,042 · 10th to 90th $1,445 to $24,547
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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $6,456.54 Typical High $12,882.50 | Facility | None | $1,380.38 | $6,456.54 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $5,495.41 | Professional | None | $1,737.80 | $1,905.46 | $5,495.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | RR · Rental | $1,737.80 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | UE · Used equipment | $1,318.26 | $1,318.26 | $1,318.26 |
Blue Shield Setting Facility Modifier None Typical Low $2,290.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $2,290.87 | $5,623.41 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $4,265.80 Median $8,128.31 Typical High $14,454.40 | Professional | None | $4,265.80 | $8,128.31 | $14,454.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,659.59 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,659.59 | $2,290.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,479.11 Median $3,890.45 Typical High $4,365.16 | Professional | None | $1,479.11 | $3,890.45 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $6,918.31 | Professional | None | $2,344.23 | $2,884.03 | $6,918.31 |
Lucent Health Setting Professional Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $24,547.09 | Professional | None | $18,620.87 | $18,620.87 | $24,547.09 |
Molina Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $954.99 Median $2,290.87 Typical High $3,890.45 | Facility | None | $954.99 | $2,290.87 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,659.59 | $2,290.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | None | $7,244.36 | $7,244.36 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,778.28 | $1,905.46 | $1,905.46 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $4,897.79 | Professional | None | $1,380.38 | $1,905.46 | $4,897.79 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Where California sits
The same service costs 2.8 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
$2,042
HI $4,365PA $1,549
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.