How much rates vary
Facilitymedian $3,548 · 10th to 90th $2,884 to $14,791Professionalmedian $5,012 · 10th to 90th $3,467 to $53,703
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 $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $12,022.64 Typical High $23,442.29 | Facility | None | $3,388.44 | $12,022.64 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $10,471.29 | Professional | None | $4,265.80 | $5,495.41 | $10,471.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | RR · Rental | $4,265.80 | $4,265.80 | $4,265.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | UE · Used equipment | $3,235.94 | $3,235.94 | $3,235.94 |
Blue Shield Setting Facility Modifier None Typical Low $4,265.80 Median $10,232.93 Typical High $17,378.01 | Facility | None | $4,265.80 | $10,232.93 | $17,378.01 |
Blue Shield Setting Professional Modifier None Typical Low $7,943.28 Median $14,791.08 Typical High $26,302.68 | Professional | None | $7,943.28 | $14,791.08 | $26,302.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $5,754.40 | Professional | None | $2,570.40 | $2,818.38 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,570.40 Median $7,244.36 Typical High $7,943.28 | Professional | None | $2,570.40 | $7,244.36 | $7,943.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,265.80 Median $5,888.44 Typical High $12,589.25 | Professional | None | $4,265.80 | $5,888.44 | $12,589.25 |
Lucent Health Setting Professional Modifier None Typical Low $47,863.01 Median $47,863.01 Typical High $53,703.18 | Professional | None | $47,863.01 | $47,863.01 | $53,703.18 |
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 $2,344.23 Median $4,677.35 Typical High $7,244.36 | Facility | None | $2,344.23 | $4,677.35 | $7,244.36 |
Providence Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Sutter Health Plus Setting Professional Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $13,182.57 | Professional | None | $13,182.57 | $13,182.57 | $13,182.57 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $3,548.13 | Facility | None | $2,884.03 | $3,548.13 | $3,548.13 |
United Setting Professional Modifier None Typical Low $3,311.31 Median $4,265.80 Typical High $8,912.51 | Professional | None | $3,311.31 | $4,265.80 | $8,912.51 |
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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $426.58 |
Where California sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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· 29th of 51
$4,677
AR $8,128VT $3,467
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.