How much rates vary
Facilitymedian $7,244 · 10th to 90th $6,026 to $30,200Professionalmedian $9,772 · 10th to 90th $6,918 to $109,648
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 $8,511.38 Median $8,511.38 Typical High $8,511.38 | Facility | None | $8,511.38 | $8,511.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $24,547.09 Typical High $47,863.01 | Facility | None | $6,918.31 | $24,547.09 | $47,863.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $8,511.38 Median $10,715.19 Typical High $20,892.96 | Professional | None | $8,511.38 | $10,715.19 | $20,892.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8,511.38 Median $8,709.64 Typical High $8,709.64 | Professional | RR · Rental | $8,511.38 | $8,709.64 | $8,709.64 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6,456.54 Median $6,606.93 Typical High $6,606.93 | Professional | UE · Used equipment | $6,456.54 | $6,606.93 | $6,606.93 |
Blue Shield Setting Facility Modifier None Typical Low $8,709.64 Median $20,892.96 Typical High $35,481.34 | Facility | None | $8,709.64 | $20,892.96 | $35,481.34 |
Blue Shield Setting Professional Modifier None Typical Low $16,218.10 Median $30,199.52 Typical High $53,703.18 | Professional | None | $16,218.10 | $30,199.52 | $53,703.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,754.40 Typical High $11,748.98 | Professional | None | $5,248.07 | $5,754.40 | $11,748.98 |
Cigna Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $9,332.54 | Professional | None | $6,918.31 | $6,918.31 | $9,332.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $5,248.07 Median $14,791.08 Typical High $16,218.10 | Professional | None | $5,248.07 | $14,791.08 | $16,218.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8,709.64 Median $12,022.64 Typical High $25,703.96 | Professional | None | $8,709.64 | $12,022.64 | $25,703.96 |
Lucent Health Setting Professional Modifier None Typical Low $97,723.72 Median $97,723.72 Typical High $109,647.82 | Professional | None | $97,723.72 | $97,723.72 | $109,647.82 |
Molina Setting Professional Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $15,848.93 | Professional | None | $15,848.93 | $15,848.93 | $15,848.93 |
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 $4,786.30 Median $9,332.54 Typical High $14,791.08 | Facility | None | $4,786.30 | $9,332.54 | $14,791.08 |
Providence Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $9,332.54 | Professional | None | $6,918.31 | $6,918.31 | $9,332.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $26,915.35 Median $26,915.35 Typical High $26,915.35 | Professional | None | $26,915.35 | $26,915.35 | $26,915.35 |
United Setting Facility Modifier None Typical Low $6,025.60 Median $7,244.36 Typical High $7,244.36 | Facility | None | $6,025.60 | $7,244.36 | $7,244.36 |
United Setting Professional Modifier None Typical Low $6,760.83 Median $8,709.64 Typical High $18,620.87 | Professional | None | $6,760.83 | $8,709.64 | $18,620.87 |
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 $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | 52 · Reduced service | $4,265.80 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 53 · Discontinued | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 55 · Aftercare only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 56 · Pre-op care only | $851.14 | $851.14 | $851.14 |
Where California sits
The same service costs 2.8 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· 26th of 51
$9,333
MT $19,498DE $6,918
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.