How much rates vary
Facilitymedian $81 · 10th to 90th $28 to $2,138Professionalmedian $52 · 10th to 90th $39 to $81
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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $54.95 Typical High $229.09 | Facility | None | $42.66 | $54.95 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $69.18 | Professional | None | $38.90 | $51.29 | $69.18 |
BCBS Alabama Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $107.15 | Facility | None | $104.71 | $107.15 | $107.15 |
BCBS Arizona Setting Facility Modifier None Typical Low $27.54 Median $66.07 Typical High $173.78 | Facility | None | $27.54 | $66.07 | $173.78 |
BCBS Arizona Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | None | $54.95 | $54.95 | $69.18 |
BCBS Louisiana Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
BCBS Mississippi Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
BCBS Nebraska Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $245.47 | Facility | None | $91.20 | $123.03 | $245.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | None | $75.86 | $100.00 | $100.00 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $17,782.79 | Facility | None | $0.02 | $0.02 | $17,782.79 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
CareSource Setting Facility Modifier None Typical Low $70,794.58 Median $70,794.58 Typical High $70,794.58 | Facility | None | $70,794.58 | $70,794.58 | $70,794.58 |
CareSource Setting Professional Modifier None Typical Low $74,131.02 Median $74,131.02 Typical High $74,131.02 | Professional | None | $74,131.02 | $74,131.02 | $74,131.02 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Denver HMP Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $114.82 | Facility | None | $81.28 | $81.28 | $114.82 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $346.74 | Professional | None | $100.00 | $151.36 | $346.74 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $407.38 | Professional | None | $128.82 | $173.78 | $407.38 |
Martin's Point Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $138.04 | Facility | None | $81.28 | $114.82 | $138.04 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $50.12 | Professional | None | $30.20 | $30.20 | $50.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $89.13 Typical High $114.82 | Facility | None | $81.28 | $89.13 | $114.82 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,011.87 | Facility | None | $4,265.80 | $4,265.80 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,128.61 | Professional | None | $5,011.87 | $5,011.87 | $5,128.61 |
Sentara Setting Facility Modifier None Typical Low $891.25 Median $2,570.40 Typical High $11,481.54 | Facility | None | $891.25 | $2,570.40 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $7,413.10 Median $10,232.93 Typical High $11,481.54 | Professional | None | $7,413.10 | $10,232.93 | $11,481.54 |
Well Sense Setting Facility Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,951.21 | $3,630.78 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
8 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 Facility Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
What it costs in each state
The same service costs 173780.1 times more in Massachusetts than in Louisiana. 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.
Touch or drag across the chart to see any state's rate.
MA $3,467LA $0.02
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.