How much rates vary
Facilitymedian $1,514 · 10th to 90th $1,349 to $6,026Professionalmedian $1,622 · 10th to 90th $1,047 to $20,417
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 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $5,128.61 Typical High $10,232.93 | Facility | None | $1,096.48 | $5,128.61 | $10,232.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $4,365.16 | Professional | None | $1,380.38 | $1,862.09 | $4,365.16 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | RR · Rental | $1,380.38 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | UE · Used equipment | $1,023.29 | $1,047.13 | $1,047.13 |
Blue Shield Setting Facility Modifier None Typical Low $1,819.70 Median $4,466.84 Typical High $7,413.10 | Facility | None | $1,819.70 | $4,466.84 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $3,388.44 Median $6,309.57 Typical High $11,481.54 | Professional | None | $3,388.44 | $6,309.57 | $11,481.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $2,454.71 | Professional | None | $812.83 | $891.25 | $2,454.71 |
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 $1,047.13 Median $1,047.13 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,047.13 | $1,412.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $812.83 Median $3,090.30 Typical High $3,388.44 | Professional | None | $812.83 | $3,090.30 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $5,370.32 | Professional | None | $1,862.09 | $2,187.76 | $5,370.32 |
Lucent Health Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $20,417.38 | Professional | None | $14,791.08 | $14,791.08 | $20,417.38 |
Molina Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $1,412.54 Typical High $3,090.30 | Facility | None | $758.58 | $1,412.54 | $3,090.30 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,047.13 | $1,412.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,348.96 | $1,513.56 | $1,513.56 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,071.52 | $1,513.56 | $3,890.45 |
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 3.2 times more in Hawaii than in Delaware. 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· 28th of 51
$1,514
HI $3,388DE $1,047
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.