How much rates vary
Facilitymedian $4,365 · 10th to 90th $2,884 to $12,882Professionalmedian $3,162 · 10th to 90th $2,399 to $45,709
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 $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $10,964.78 Typical High $21,877.62 | Facility | None | $2,344.23 | $10,964.78 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $9,120.11 | Professional | None | $2,951.21 | $3,801.89 | $9,120.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | RR · Rental | $2,951.21 | $2,951.21 | $2,951.21 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,187.76 Median $2,187.76 Typical High $2,238.72 | Professional | UE · Used equipment | $2,187.76 | $2,187.76 | $2,238.72 |
Blue Shield Setting Facility Modifier None Typical Low $3,890.45 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,890.45 | $9,332.54 | $15,848.93 |
Blue Shield Setting Professional Modifier None Typical Low $7,244.36 Median $13,489.63 Typical High $23,988.33 | Professional | None | $7,244.36 | $13,489.63 | $23,988.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,548.13 Typical High $5,248.07 | Professional | None | $3,235.94 | $3,548.13 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,235.94 Median $6,606.93 Typical High $7,244.36 | Professional | None | $3,235.94 | $6,606.93 | $7,244.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $11,481.54 | Professional | None | $3,981.07 | $5,888.44 | $11,481.54 |
Lucent Health Setting Professional Modifier None Typical Low $45,708.82 Median $45,708.82 Typical High $45,708.82 | Professional | None | $45,708.82 | $45,708.82 | $45,708.82 |
Molina Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
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 $1,584.89 Median $3,548.13 Typical High $6,606.93 | Facility | None | $1,584.89 | $3,548.13 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $4,365.16 | Facility | None | $3,235.94 | $4,365.16 | $4,365.16 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $8,128.31 | Professional | None | $2,290.87 | $3,162.28 | $8,128.31 |
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
Where California sits
The same service costs 4.3 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· 22nd of 51
$3,467
HI $11,220PA $2,630
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.