How much rates vary
Facilitymedian $1,072 · 10th to 90th $794 to $4,365Professionalmedian $1,349 · 10th to 90th $933 to $14,454
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,630.78 Typical High $7,244.36 | Facility | None | $891.25 | $3,630.78 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,479.11 | $3,090.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | RR · Rental | $1,148.15 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | UE · Used equipment | $851.14 | $851.14 | $851.14 |
Blue Shield Setting Facility Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $5,248.07 | Facility | None | $1,288.25 | $3,162.28 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $2,398.83 Median $4,466.84 Typical High $8,128.31 | Professional | None | $2,398.83 | $4,466.84 | $8,128.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,737.80 | Professional | None | $831.76 | $912.01 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,148.15 | $1,584.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $831.76 Median $2,187.76 Typical High $2,398.83 | Professional | None | $831.76 | $2,187.76 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,801.89 | Professional | None | $1,318.26 | $1,584.89 | $3,801.89 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $14,454.40 | Professional | None | $11,481.54 | $11,481.54 | $14,454.40 |
Molina Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,584.89 Typical High $2,187.76 | Facility | None | $616.60 | $1,584.89 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,148.15 | $1,584.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,071.52 | Facility | None | $794.33 | $1,071.52 | $1,071.52 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $2,754.23 | Professional | None | $891.25 | $1,122.02 | $2,754.23 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Where California sits
The same service costs 2.3 times more in Wisconsin 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
$1,349
WI $2,455DC $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.