How much rates vary
Facilitymedian $1,862 · 10th to 90th $1,622 to $7,586Professionalmedian $2,042 · 10th to 90th $1,288 to $26,915
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 $6,309.57 Typical High $12,589.25 | Facility | None | $1,380.38 | $6,309.57 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $5,370.32 | Professional | None | $1,737.80 | $2,344.23 | $5,370.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | RR · Rental | $1,737.80 | $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 $1,318.26 | Professional | UE · Used equipment | $1,288.25 | $1,288.25 | $1,318.26 |
Blue Shield Setting Facility Modifier None Typical Low $2,238.72 Median $5,370.32 Typical High $9,120.11 | Facility | None | $2,238.72 | $5,370.32 | $9,120.11 |
Blue Shield Setting Professional Modifier None Typical Low $4,168.69 Median $7,762.47 Typical High $13,803.84 | Professional | None | $4,168.69 | $7,762.47 | $13,803.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $3,019.95 | Professional | None | $977.24 | $1,096.48 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $977.24 Median $3,801.89 Typical High $4,168.69 | Professional | None | $977.24 | $3,801.89 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $6,606.93 | Professional | None | $2,290.87 | $2,691.53 | $6,606.93 |
Lucent Health Setting Professional Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $26,915.35 | Professional | None | $18,197.01 | $18,197.01 | $26,915.35 |
Molina Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $1,778.28 Typical High $3,801.89 | Facility | None | $954.99 | $1,778.28 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,621.81 | $1,862.09 | $1,862.09 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $4,677.35 | Professional | None | $1,348.96 | $1,862.09 | $4,677.35 |
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 3.2 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· 26th of 51
$1,862
HI $4,169DE $1,288
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.