How much rates vary
Facilitymedian $479 · 10th to 90th $66 to $4,898Professionalmedian $62 · 10th to 90th $39 to $240
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 $39.81 Median $54.95 Typical High $66.07 | Facility | None | $39.81 | $54.95 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $107.15 | Professional | None | $39.81 | $61.66 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,137.96 | $4,786.30 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $56.23 Typical High $169.82 | Professional | None | $38.02 | $56.23 | $169.82 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $416.87 Typical High $1,479.11 | Facility | None | $95.50 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $33.11 Median $51.29 Typical High $93.33 | Professional | None | $33.11 | $51.29 | $93.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $125.89 | Professional | None | $38.02 | $50.12 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $109.65 | Professional | None | $44.67 | $66.07 | $109.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $123.03 | Professional | None | $32.36 | $50.12 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $95.50 Typical High $173.78 | Professional | None | $42.66 | $95.50 | $173.78 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $776.25 | Professional | None | $575.44 | $575.44 | $776.25 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | None | $67.61 | $67.61 | $112.20 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $676.08 | Facility | None | $50.12 | $66.07 | $676.08 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $109.65 | Professional | None | $44.67 | $66.07 | $109.65 |
Sutter Health Plus Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $239.88 | Professional | None | $147.91 | $147.91 | $239.88 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $36.31 Median $60.26 Typical High $131.83 | Professional | None | $36.31 | $60.26 | $131.83 |
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 $19.95 Median $20.89 Typical High $33.11 | Facility | 52 · Reduced service | $19.95 | $20.89 | $33.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.94 Median $8.32 Typical High $13.18 | Facility | 53 · Discontinued | $7.94 | $8.32 | $13.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $6.17 Typical High $10.00 | Facility | 55 · Aftercare only | $6.03 | $6.17 | $10.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.17 Typical High $6.61 | Facility | 56 · Pre-op care only | $3.98 | $4.17 | $6.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $26.92 Typical High $33.11 | Professional | 52 · Reduced service | $19.50 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.96 Typical High $13.18 | Professional | 53 · Discontinued | $7.94 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.13 Typical High $10.00 | Professional | 55 · Aftercare only | $5.89 | $8.13 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.89 | $5.50 | $6.61 |
Where California sits
The same service costs 3.3 times more in Alaska 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· 45th of 51
$63.10
AK $191NJ $57.54
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.