How much rates vary
Facilitymedian $1,514 · 10th to 90th $813 to $3,631Professionalmedian $955 · 10th to 90th $631 to $13,183
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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $6,025.60 | Facility | None | $645.65 | $3,019.95 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,630.27 | Professional | None | $812.83 | $1,071.52 | $2,630.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | RR · Rental | $812.83 | $812.83 | $812.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | UE · Used equipment | $616.60 | $616.60 | $616.60 |
Blue Shield Setting Facility Modifier None Typical Low $1,071.52 Median $2,630.27 Typical High $4,365.16 | Facility | None | $1,071.52 | $2,630.27 | $4,365.16 |
Blue Shield Setting Professional Modifier None Typical Low $1,995.26 Median $3,715.35 Typical High $6,760.83 | Professional | None | $1,995.26 | $3,715.35 | $6,760.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,479.11 | Professional | None | $954.99 | $1,047.13 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $870.96 | Professional | None | $630.96 | $630.96 | $870.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $954.99 Median $1,819.70 Typical High $1,995.26 | Professional | None | $954.99 | $1,819.70 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,096.48 | $1,659.59 | $3,548.13 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $13,182.57 | Professional | None | $10,232.93 | $10,232.93 | $13,182.57 |
Molina Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $446.68 Median $870.96 Typical High $1,819.70 | Facility | None | $446.68 | $870.96 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $870.96 | Professional | None | $630.96 | $630.96 | $870.96 |
Sutter Health Plus 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 |
United Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,513.56 | Facility | None | $891.25 | $1,513.56 | $1,513.56 |
United Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $2,290.87 | Professional | None | $645.65 | $891.25 | $2,290.87 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Where California sits
The same service costs 4.0 times more in Hawaii 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
$955
HI $2,512DE $631
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.