How much rates vary
Facilitymedian $5,129 · 10th to 90th $4,365 to $21,878Professionalmedian $6,607 · 10th to 90th $4,571 to $70,795
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 $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $17,378.01 Typical High $34,673.69 | Facility | None | $4,466.84 | $17,378.01 | $34,673.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $7,413.10 Typical High $14,791.08 | Professional | None | $5,623.41 | $7,413.10 | $14,791.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | RR · Rental | $5,623.41 | $5,623.41 | $5,623.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | UE · Used equipment | $4,265.80 | $4,265.80 | $4,265.80 |
Blue Shield Setting Facility Modifier None Typical Low $6,165.95 Median $14,791.08 Typical High $25,118.86 | Facility | None | $6,165.95 | $14,791.08 | $25,118.86 |
Blue Shield Setting Professional Modifier None Typical Low $11,481.54 Median $21,379.62 Typical High $38,018.94 | Professional | None | $11,481.54 | $21,379.62 | $38,018.94 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3,801.89 Median $4,168.69 Typical High $8,317.64 | Professional | None | $3,801.89 | $4,168.69 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,801.89 Median $10,471.29 Typical High $11,481.54 | Professional | None | $3,801.89 | $10,471.29 | $11,481.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,309.57 Median $7,244.36 Typical High $18,197.01 | Professional | None | $6,309.57 | $7,244.36 | $18,197.01 |
Lucent Health Setting Professional Modifier None Typical Low $53,703.18 Median $53,703.18 Typical High $70,794.58 | Professional | None | $53,703.18 | $53,703.18 | $70,794.58 |
Molina Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | None | $9,332.54 | $9,332.54 | $9,332.54 |
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 $3,090.30 Median $7,244.36 Typical High $10,471.29 | Facility | None | $3,090.30 | $7,244.36 | $10,471.29 |
Providence Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
Sutter Health Plus Setting Professional Modifier None Typical Low $19,498.45 Median $19,498.45 Typical High $19,498.45 | Professional | None | $19,498.45 | $19,498.45 | $19,498.45 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $5,128.61 | Facility | None | $4,365.16 | $5,128.61 | $5,128.61 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $5,623.41 Typical High $12,882.50 | Professional | None | $4,365.16 | $5,623.41 | $12,882.50 |
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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,754.23 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $549.54 | $549.54 | $549.54 |
Where California sits
The same service costs 2.1 times more in Hawaii than in Colorado. 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· 24th of 51
$6,607
HI $11,220CO $5,248
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.