How much rates vary
Facilitymedian $6,166 · 10th to 90th $5,129 to $26,303Professionalmedian $8,710 · 10th to 90th $6,166 to $95,499
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 $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $20,892.96 Typical High $40,738.03 | Facility | None | $5,888.44 | $20,892.96 | $40,738.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $7,413.10 Median $9,549.93 Typical High $17,782.79 | Professional | None | $7,413.10 | $9,549.93 | $17,782.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | RR · Rental | $7,413.10 | $7,413.10 | $7,413.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | UE · Used equipment | $5,623.41 | $5,623.41 | $5,623.41 |
Blue Shield Setting Facility Modifier None Typical Low $7,413.10 Median $17,782.79 Typical High $30,199.52 | Facility | None | $7,413.10 | $17,782.79 | $30,199.52 |
Blue Shield Setting Professional Modifier None Typical Low $13,803.84 Median $25,703.96 Typical High $45,708.82 | Professional | None | $13,803.84 | $25,703.96 | $45,708.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4,570.88 Median $5,011.87 Typical High $10,000.00 | Professional | None | $4,570.88 | $5,011.87 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $4,570.88 Median $12,589.25 Typical High $13,803.84 | Professional | None | $4,570.88 | $12,589.25 | $13,803.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,413.10 Median $10,715.19 Typical High $21,877.62 | Professional | None | $7,413.10 | $10,715.19 | $21,877.62 |
Lucent Health Setting Professional Modifier None Typical Low $83,176.38 Median $83,176.38 Typical High $95,499.26 | Professional | None | $83,176.38 | $83,176.38 | $95,499.26 |
Molina Setting Professional Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Professional | None | $13,489.63 | $13,489.63 | $13,489.63 |
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 $4,073.80 Median $9,120.11 Typical High $12,589.25 | Facility | None | $4,073.80 | $9,120.11 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $22,908.68 Median $22,908.68 Typical High $22,908.68 | Professional | None | $22,908.68 | $22,908.68 | $22,908.68 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $6,165.95 Typical High $6,165.95 | Facility | None | $5,128.61 | $6,165.95 | $6,165.95 |
United Setting Professional Modifier None Typical Low $5,754.40 Median $7,413.10 Typical High $15,848.93 | Professional | None | $5,754.40 | $7,413.10 | $15,848.93 |
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 $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | 52 · Reduced service | $3,715.35 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 53 · Discontinued | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 55 · Aftercare only | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 56 · Pre-op care only | $741.31 | $741.31 | $741.31 |
Where California sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$8,710
MT $16,596DE $6,607
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.