How much rates vary
Facilitymedian $1,000 · 10th to 90th $832 to $3,631Professionalmedian $977 · 10th to 90th $692 to $10,471
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 $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $3,090.30 Typical High $6,165.95 | Facility | None | $660.69 | $3,090.30 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $2,630.27 | Professional | None | $831.76 | $1,071.52 | $2,630.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | RR · Rental | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | UE · Used equipment | $630.96 | $630.96 | $630.96 |
Blue Shield Setting Facility Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $4,466.84 | Facility | None | $1,096.48 | $2,691.53 | $4,466.84 |
Blue Shield Setting Professional Modifier None Typical Low $2,041.74 Median $3,801.89 Typical High $6,918.31 | Professional | None | $2,041.74 | $3,801.89 | $6,918.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $1,479.11 | Professional | None | $346.74 | $380.19 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $346.74 Median $1,862.09 Typical High $2,041.74 | Professional | None | $346.74 | $1,862.09 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,479.11 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $10,471.29 | Professional | None | $9,772.37 | $9,772.37 | $10,471.29 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $457.09 Median $1,047.13 Typical High $1,862.09 | Facility | None | $457.09 | $1,047.13 | $1,862.09 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Facility | None | $912.01 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $2,344.23 | Professional | None | $645.65 | $912.01 | $2,344.23 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
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· 22nd of 51
$1,000
HI $2,344PA $759
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.