How much rates vary
Facilitymedian $8,913 · 10th to 90th $7,586 to $38,019Professionalmedian $11,749 · 10th to 90th $8,511 to $128,825
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 $10,232.93 Median $10,232.93 Typical High $10,232.93 | Facility | None | $10,232.93 | $10,232.93 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None | $10,232.93 | $10,232.93 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $30,199.52 Typical High $60,255.96 | Facility | None | $8,128.31 | $30,199.52 | $60,255.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,232.93 Median $13,489.63 Typical High $25,703.96 | Professional | None | $10,232.93 | $13,489.63 | $25,703.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | RR · Rental | $10,232.93 | $10,232.93 | $10,232.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | UE · Used equipment | $7,762.47 | $7,762.47 | $7,762.47 |
Blue Shield Setting Facility Modifier None Typical Low $10,715.19 Median $26,302.68 Typical High $43,651.58 | Facility | None | $10,715.19 | $26,302.68 | $43,651.58 |
Blue Shield Setting Professional Modifier None Typical Low $19,952.62 Median $37,153.52 Typical High $67,608.30 | Professional | None | $19,952.62 | $37,153.52 | $67,608.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $6,606.93 Median $7,413.10 Typical High $14,454.40 | Professional | None | $6,606.93 | $7,413.10 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Facility | None | $11,748.98 | $11,748.98 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $11,748.98 | Professional | None | $8,511.38 | $8,511.38 | $11,748.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $6,606.93 Median $18,197.01 Typical High $19,952.62 | Professional | None | $6,606.93 | $18,197.01 | $19,952.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10,964.78 Median $14,454.40 Typical High $31,622.78 | Professional | None | $10,964.78 | $14,454.40 | $31,622.78 |
Lucent Health Setting Professional Modifier None Typical Low $114,815.36 Median $114,815.36 Typical High $128,824.96 | Professional | None | $114,815.36 | $114,815.36 | $128,824.96 |
Molina 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 |
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 $5,623.41 Median $11,748.98 Typical High $18,197.01 | Facility | None | $5,623.41 | $11,748.98 | $18,197.01 |
Providence Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $11,748.98 | Professional | None | $8,511.38 | $8,511.38 | $11,748.98 |
Sutter Health Plus Setting Professional Modifier None Typical Low $33,884.42 Median $33,884.42 Typical High $33,884.42 | Professional | None | $33,884.42 | $33,884.42 | $33,884.42 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $8,912.51 Typical High $8,912.51 | Facility | None | $7,585.78 | $8,912.51 | $8,912.51 |
United Setting Professional Modifier None Typical Low $8,128.31 Median $10,232.93 Typical High $22,908.68 | Professional | None | $8,128.31 | $10,232.93 | $22,908.68 |
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 $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | 52 · Reduced service | $5,128.61 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 53 · Discontinued | $2,041.74 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 55 · Aftercare only | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $1,023.29 | $1,023.29 | $1,023.29 |
Where California sits
The same service costs 2.6 times more in Montana than in New Jersey. 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
$11,749
MT $21,878NJ $8,511
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.