How much rates vary
Facilitymedian $832 · 10th to 90th $646 to $3,467Professionalmedian $1,175 · 10th to 90th $832 to $12,589
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,818.38 Typical High $5,495.41 | Facility | None | $794.33 | $2,818.38 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,318.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | RR · Rental | $1,000.00 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | UE · Used equipment | $758.58 | $758.58 | $758.58 |
Blue Shield Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $4,073.80 | Facility | None | $1,000.00 | $2,398.83 | $4,073.80 |
Blue Shield Setting Professional Modifier None Typical Low $1,862.09 Median $3,467.37 Typical High $6,165.95 | Professional | None | $1,862.09 | $3,467.37 | $6,165.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,348.96 | Professional | None | $645.65 | $707.95 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None | $977.24 | $977.24 | $1,318.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $645.65 Median $1,698.24 Typical High $1,862.09 | Professional | None | $645.65 | $1,698.24 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,513.56 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $12,589.25 | Professional | None | $11,220.18 | $11,220.18 | $12,589.25 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $549.54 Median $1,318.26 Typical High $1,698.24 | Facility | None | $549.54 | $1,318.26 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None | $977.24 | $977.24 | $1,318.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
United Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $831.76 | Facility | None | $645.65 | $831.76 | $831.76 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $2,137.96 | Professional | None | $776.25 | $1,000.00 | $2,137.96 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Where California sits
The same service costs 2.5 times more in Montana than in Pennsylvania. 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· 22nd of 51
$1,175
MT $2,239PA $891
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.