How much rates vary
Facilitymedian $1,698 · 10th to 90th $1,479 to $6,026Professionalmedian $1,778 · 10th to 90th $1,122 to $19,055
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $5,011.87 Typical High $10,000.00 | Facility | None | $1,202.26 | $5,011.87 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $4,168.69 | Professional | None | $1,513.56 | $2,041.74 | $4,168.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | RR · Rental | $1,513.56 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,122.02 Median $1,122.02 Typical High $1,148.15 | Professional | UE · Used equipment | $1,122.02 | $1,122.02 | $1,148.15 |
Blue Shield Setting Facility Modifier None Typical Low $1,778.28 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,778.28 | $4,265.80 | $7,244.36 |
Blue Shield Setting Professional Modifier None Typical Low $3,311.31 Median $6,165.95 Typical High $10,964.78 | Professional | None | $3,311.31 | $6,165.95 | $10,964.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,737.80 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $3,311.31 | Professional | None | $1,584.89 | $3,019.95 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $5,248.07 | Professional | None | $1,819.70 | $2,398.83 | $5,248.07 |
Lucent Health Setting Professional Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $19,054.61 | Professional | None | $16,218.10 | $16,218.10 | $19,054.61 |
Molina 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 |
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 $831.76 Median $1,548.82 Typical High $3,019.95 | Facility | None | $831.76 | $1,548.82 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,479.11 | $1,698.24 | $1,698.24 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $3,715.35 | Professional | None | $1,174.90 | $1,513.56 | $3,715.35 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
Where California sits
The same service costs 3.0 times more in Iowa 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· 23rd of 51
$1,698
IA $3,311DE $1,122
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.