How much rates vary
Facilitymedian $5,248 · 10th to 90th $4,467 to $22,387Professionalmedian $7,586 · 10th to 90th $5,248 to $85,114
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 $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $17,782.79 Typical High $35,481.34 | Facility | None | $5,011.87 | $17,782.79 | $35,481.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,456.54 Median $8,317.64 Typical High $15,488.17 | Professional | None | $6,456.54 | $8,317.64 | $15,488.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | RR · Rental | $6,456.54 | $6,456.54 | $6,456.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | UE · Used equipment | $4,786.30 | $4,786.30 | $4,786.30 |
Blue Shield Setting Facility Modifier None Typical Low $6,309.57 Median $15,488.17 Typical High $25,703.96 | Facility | None | $6,309.57 | $15,488.17 | $25,703.96 |
Blue Shield Setting Professional Modifier None Typical Low $11,748.98 Median $21,877.62 Typical High $39,810.72 | Professional | None | $11,748.98 | $21,877.62 | $39,810.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $8,511.38 | Professional | None | $3,981.07 | $4,365.16 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $8,128.31 | Professional | None | $5,888.44 | $5,888.44 | $8,128.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,981.07 Median $10,715.19 Typical High $11,748.98 | Professional | None | $3,981.07 | $10,715.19 | $11,748.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,456.54 Median $8,912.51 Typical High $18,620.87 | Professional | None | $6,456.54 | $8,912.51 | $18,620.87 |
Lucent Health Setting Professional Modifier None Typical Low $70,794.58 Median $70,794.58 Typical High $85,113.80 | Professional | None | $70,794.58 | $70,794.58 | $85,113.80 |
Molina Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Professional | None | $11,748.98 | $11,748.98 | $11,748.98 |
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 $3,467.37 Median $8,128.31 Typical High $10,715.19 | Facility | None | $3,467.37 | $8,128.31 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $8,128.31 | Professional | None | $5,888.44 | $5,888.44 | $8,128.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $19,952.62 Median $19,952.62 Typical High $19,952.62 | Professional | None | $19,952.62 | $19,952.62 | $19,952.62 |
United Setting Facility Modifier None Typical Low $4,466.84 Median $5,248.07 Typical High $5,248.07 | Facility | None | $4,466.84 | $5,248.07 | $5,248.07 |
United Setting Professional Modifier None Typical Low $5,011.87 Median $6,309.57 Typical High $13,803.84 | Professional | None | $5,011.87 | $6,309.57 | $13,803.84 |
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 $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 53 · Discontinued | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $630.96 | $630.96 | $630.96 |
Where California sits
The same service costs 2.5 times more in Montana than in West Virginia. 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
$7,586
MT $14,454WV $5,888
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.