How much rates vary
Facilitymedian $3,388 · 10th to 90th $2,291 to $11,220Professionalmedian $2,884 · 10th to 90th $2,042 to $32,359
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $8,128.31 Typical High $16,218.10 | Facility | None | $1,949.84 | $8,128.31 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $6,918.31 | Professional | None | $2,398.83 | $2,691.53 | $6,918.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Professional | RR · Rental | $2,454.71 | $2,454.71 | $2,511.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $1,862.09 Typical High $1,905.46 | Professional | UE · Used equipment | $1,862.09 | $1,862.09 | $1,905.46 |
Blue Shield Setting Facility Modifier None Typical Low $2,884.03 Median $7,079.46 Typical High $11,748.98 | Facility | None | $2,884.03 | $7,079.46 | $11,748.98 |
Blue Shield Setting Professional Modifier None Typical Low $5,370.32 Median $10,232.93 Typical High $18,197.01 | Professional | None | $5,370.32 | $10,232.93 | $18,197.01 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $3,981.07 | Professional | None | $1,348.96 | $1,479.11 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,348.96 Median $4,897.79 Typical High $5,495.41 | Professional | None | $1,348.96 | $4,897.79 | $5,495.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $8,709.64 | Professional | None | $2,951.21 | $3,467.37 | $8,709.64 |
Lucent Health Setting Professional Modifier None Typical Low $24,547.09 Median $24,547.09 Typical High $32,359.37 | Professional | None | $24,547.09 | $24,547.09 | $32,359.37 |
Molina Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $1,348.96 Median $3,388.44 Typical High $4,897.79 | Facility | None | $1,348.96 | $3,388.44 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $6,165.95 | Professional | None | $1,949.84 | $2,454.71 | $6,165.95 |
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Where California sits
The same service costs 2.1 times more in Montana than in South Carolina. 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
$2,884
MT $4,898SC $2,344
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.