How much rates vary
Facilitymedian $355 · 10th to 90th $98 to $2,818Professionalmedian $87 · 10th to 90th $63 to $229
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 $63.10 Median $81.28 Typical High $162.18 | Facility | None | $63.10 | $81.28 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $158.49 | Professional | None | $63.10 | $87.10 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | None | $114.82 | $114.82 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $213.80 | Professional | None | $66.07 | $67.61 | $213.80 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $120.23 | Professional | None | $51.29 | $75.86 | $120.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $158.49 | Professional | None | $74.13 | $125.89 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $120.23 Typical High $251.19 | Facility | None | $53.70 | $120.23 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $147.91 | Professional | None | $67.61 | $93.33 | $147.91 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $151.36 | Professional | None | $75.86 | $95.50 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $223.87 | Professional | None | $67.61 | $117.49 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $933.25 | Professional | None | $724.44 | $724.44 | $933.25 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $138.04 | Professional | None | $83.18 | $83.18 | $138.04 |
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 $58.88 Median $117.49 Typical High $251.19 | Facility | None | $58.88 | $117.49 | $251.19 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $141.25 | Professional | None | $67.61 | $93.33 | $141.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $309.03 | Professional | None | $218.78 | $218.78 | $309.03 |
United Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $1,096.48 | Facility | None | $194.98 | $354.81 | $1,096.48 |
United Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $162.18 | Professional | None | $54.95 | $83.18 | $162.18 |
10 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 $31.62 Median $33.88 Typical High $48.98 | Facility | 52 · Reduced service | $31.62 | $33.88 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $13.49 Typical High $19.50 | Facility | 53 · Discontinued | $12.59 | $13.49 | $19.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $14.45 | Facility | 55 · Aftercare only | $9.33 | $10.23 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.76 Typical High $9.77 | Facility | 56 · Pre-op care only | $6.31 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $38.90 Typical High $48.98 | Professional | 52 · Reduced service | $29.51 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $11.75 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.48 Typical High $14.45 | Professional | 55 · Aftercare only | $8.71 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.89 | $7.76 | $9.77 |
Ambetter Setting Professional Modifier AG · Primary physician Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | AG · Primary physician | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $134.90 Typical High $173.78 | Professional | 50 · Both sides | $102.33 | $134.90 | $173.78 |
Where California sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 38th of 51
$91.20
AK $275KY $75.86
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.