How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,698 to $7,586Professionalmedian $2,042 · 10th to 90th $1,413 to $24,547
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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $6,456.54 Typical High $12,882.50 | Facility | None | $1,380.38 | $6,456.54 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $5,495.41 | Professional | None | $1,698.24 | $2,290.87 | $5,495.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | RR · Rental | $1,698.24 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | UE · Used equipment | $1,288.25 | $1,288.25 | $1,288.25 |
Blue Shield Setting Facility Modifier None Typical Low $2,290.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $2,290.87 | $5,623.41 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $4,265.80 Median $7,943.28 Typical High $14,454.40 | Professional | None | $4,265.80 | $7,943.28 | $14,454.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,230.27 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,513.56 | $2,041.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,122.02 Median $3,890.45 Typical High $4,265.80 | Professional | None | $1,122.02 | $3,890.45 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $6,760.83 | Professional | None | $2,344.23 | $3,019.95 | $6,760.83 |
Lucent Health Setting Professional Modifier None Typical Low $19,498.45 Median $19,498.45 Typical High $24,547.09 | Professional | None | $19,498.45 | $19,498.45 | $24,547.09 |
Molina Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
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 $954.99 Median $2,041.74 Typical High $3,890.45 | Facility | None | $954.99 | $2,041.74 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,513.56 | $2,041.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | None | $7,244.36 | $7,244.36 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,905.46 | $1,949.84 | $1,949.84 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $4,897.79 | Professional | None | $1,348.96 | $1,905.46 | $4,897.79 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Where California sits
The same service costs 3.1 times more in Hawaii 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· 24th of 51
$2,042
HI $4,677PA $1,514
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.