How much rates vary
Facilitymedian $1,318 · 10th to 90th $1,000 to $4,786Professionalmedian $1,288 · 10th to 90th $912 to $15,136
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $3,388.44 Typical High $6,760.83 | Facility | None | $870.96 | $3,388.44 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,122.02 | $1,445.44 | $2,884.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,096.48 Median $1,096.48 Typical High $1,122.02 | Professional | RR · Rental | $1,096.48 | $1,096.48 | $1,122.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | UE · Used equipment | $831.76 | $831.76 | $831.76 |
Blue Shield Setting Facility Modifier None Typical Low $1,202.26 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,202.26 | $2,884.03 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $2,238.72 Median $4,168.69 Typical High $7,413.10 | Professional | None | $2,238.72 | $4,168.69 | $7,413.10 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,174.90 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,071.52 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,071.52 | $2,041.74 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $3,548.13 | Professional | None | $1,230.27 | $1,445.44 | $3,548.13 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Professional | None | $15,135.61 | $15,135.61 | $15,135.61 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $602.56 Median $1,318.26 Typical High $2,041.74 | Facility | None | $602.56 | $1,318.26 | $2,041.74 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $2,511.89 | Professional | None | $870.96 | $1,096.48 | $2,511.89 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Where California sits
The same service costs 3.0 times more in Kansas 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· 24th of 51
$1,288
KS $2,818DE $955
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.