How much rates vary
Facilitymedian $4,467 · 10th to 90th $3,802 to $18,621Professionalmedian $5,754 · 10th to 90th $3,981 to $61,660
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 $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $15,135.61 Typical High $30,199.52 | Facility | None | $3,890.45 | $15,135.61 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $6,456.54 Typical High $12,882.50 | Professional | None | $4,897.79 | $6,456.54 | $12,882.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | RR · Rental | $4,897.79 | $4,897.79 | $4,897.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | UE · Used equipment | $3,630.78 | $3,630.78 | $3,630.78 |
Blue Shield Setting Facility Modifier None Typical Low $5,370.32 Median $13,182.57 Typical High $21,877.62 | Facility | None | $5,370.32 | $13,182.57 | $21,877.62 |
Blue Shield Setting Professional Modifier None Typical Low $10,000.00 Median $18,620.87 Typical High $33,884.42 | Professional | None | $10,000.00 | $18,620.87 | $33,884.42 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,715.35 Typical High $7,244.36 | Professional | None | $3,388.44 | $3,715.35 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,388.44 Median $9,120.11 Typical High $10,000.00 | Professional | None | $3,388.44 | $9,120.11 | $10,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,495.41 Median $6,606.93 Typical High $15,848.93 | Professional | None | $5,495.41 | $6,606.93 | $15,848.93 |
Lucent Health Setting Professional Modifier None Typical Low $48,977.88 Median $48,977.88 Typical High $61,659.50 | Professional | None | $48,977.88 | $48,977.88 | $61,659.50 |
Molina Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
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 $2,630.27 Median $6,606.93 Typical High $9,120.11 | Facility | None | $2,630.27 | $6,606.93 | $9,120.11 |
Providence Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
Sutter Health Plus Setting Professional Modifier None Typical Low $16,982.44 Median $16,982.44 Typical High $16,982.44 | Professional | None | $16,982.44 | $16,982.44 | $16,982.44 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $4,466.84 | Facility | None | $3,801.89 | $4,466.84 | $4,466.84 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $4,786.30 Typical High $11,481.54 | Professional | None | $3,801.89 | $4,786.30 | $11,481.54 |
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 $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $478.63 |
Where California sits
The same service costs 2.1 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· 25th of 51
$5,754
MT $10,000PA $4,786
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.