How much rates vary
Facilitymedian $1,318 · 10th to 90th $1,096 to $4,898Professionalmedian $1,318 · 10th to 90th $912 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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $891.25 | $4,168.69 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $3,467.37 | Professional | None | $1,047.13 | $1,202.26 | $3,467.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | RR · Rental | $1,122.02 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | UE · Used equipment | $831.76 | $831.76 | $851.14 |
Blue Shield Setting Facility Modifier None Typical Low $1,479.11 Median $3,630.78 Typical High $6,025.60 | Facility | None | $1,479.11 | $3,630.78 | $6,025.60 |
Blue Shield Setting Professional Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $9,332.54 | Professional | None | $2,754.23 | $5,128.61 | $9,332.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,380.38 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,511.89 Typical High $2,754.23 | Professional | None | $1,230.27 | $2,511.89 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $4,365.16 | Professional | None | $1,513.56 | $2,187.76 | $4,365.16 |
Lucent Health Setting Professional Modifier None Typical Low $14,454.40 Median $14,454.40 Typical High $17,378.01 | Professional | None | $14,454.40 | $14,454.40 | $17,378.01 |
Molina Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $1,412.54 Typical High $2,511.89 | Facility | None | $616.60 | $1,412.54 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,318.26 | $1,318.26 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $3,162.28 | Professional | None | $870.96 | $1,230.27 | $3,162.28 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Where California sits
The same service costs 3.6 times more in Hawaii than in Washington, DC. 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
$1,318
HI $3,548DC $977
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.