How much rates vary
Facilitymedian $1,148 · 10th to 90th $871 to $4,898Professionalmedian $1,660 · 10th to 90th $1,148 to $17,378
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,890.45 Typical High $7,762.47 | Facility | None | $1,096.48 | $3,890.45 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,698.24 | $1,862.09 | $3,388.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,380.38 Median $1,380.38 Typical High $1,778.28 | Professional | RR · Rental | $1,380.38 | $1,380.38 | $1,778.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | UE · Used equipment | $1,047.13 | $1,047.13 | $1,288.25 |
Blue Shield Setting Facility Modifier None Typical Low $1,380.38 Median $3,388.44 Typical High $5,623.41 | Facility | None | $1,380.38 | $3,388.44 | $5,623.41 |
Blue Shield Setting Professional Modifier None Typical Low $2,570.40 Median $4,786.30 Typical High $8,709.64 | Professional | None | $2,570.40 | $4,786.30 | $8,709.64 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,862.09 | Professional | None | $831.76 | $912.01 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,318.26 | $1,819.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $831.76 Median $2,344.23 Typical High $2,570.40 | Professional | None | $831.76 | $2,344.23 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,412.54 | $2,089.30 | $4,073.80 |
Lucent Health Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $17,378.01 | Professional | None | $14,791.08 | $14,791.08 | $17,378.01 |
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 $758.58 Median $1,819.70 Typical High $2,344.23 | Facility | None | $758.58 | $1,819.70 | $2,344.23 |
Providence Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,318.26 | $1,819.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
United Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,148.15 | Facility | None | $870.96 | $1,148.15 | $1,148.15 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,412.54 | $2,951.21 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Where California sits
The same service costs 2.3 times more in Wisconsin 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· 34th of 51
$1,622
WI $2,951PA $1,288
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.