How much rates vary
Facilitymedian $933 · 10th to 90th $741 to $3,981Professionalmedian $1,288 · 10th to 90th $851 to $14,454
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,162.28 Typical High $6,309.57 | Facility | None | $891.25 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,513.56 | $2,691.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,122.02 Median $1,148.15 Typical High $1,148.15 | Professional | RR · Rental | $1,122.02 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | UE · Used equipment | $851.14 | $851.14 | $851.14 |
Blue Shield Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $4,570.88 | Facility | None | $1,122.02 | $2,754.23 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $2,089.30 Median $3,890.45 Typical High $7,079.46 | Professional | None | $2,089.30 | $3,890.45 | $7,079.46 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,513.56 | Professional | None | $691.83 | $758.58 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $691.83 Median $1,905.46 Typical High $2,089.30 | Professional | None | $691.83 | $1,905.46 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,621.81 | $3,311.31 |
Lucent Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $14,454.40 | Professional | None | $12,589.25 | $12,589.25 | $14,454.40 |
Molina Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $616.60 Median $1,174.90 Typical High $1,905.46 | Facility | None | $616.60 | $1,174.90 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
United Setting Facility Modifier None Typical Low $741.31 Median $933.25 Typical High $933.25 | Facility | None | $741.31 | $933.25 | $933.25 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $2,454.71 | Professional | None | $891.25 | $1,122.02 | $2,454.71 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Where California sits
The same service costs 3.0 times more in Montana 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· 30th of 51
$1,175
MT $2,512DE $851
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.