How much rates vary
Facilitymedian $355 · 10th to 90th $91 to $2,818Professionalmedian $81 · 10th to 90th $58 to $204
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 $57.54 Median $83.18 Typical High $117.49 | Facility | None | $57.54 | $83.18 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $144.54 | Professional | None | $57.54 | $83.18 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $125.89 | Professional | None | $93.33 | $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 $58.88 Median $60.26 Typical High $194.98 | Professional | None | $58.88 | $60.26 | $194.98 |
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 $45.71 Median $69.18 Typical High $112.20 | Professional | None | $45.71 | $69.18 | $112.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $141.25 | Professional | None | $66.07 | $112.20 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $109.65 Typical High $229.09 | Facility | None | $53.70 | $109.65 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $134.90 | Professional | None | $61.66 | $87.10 | $134.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $138.04 | Professional | None | $70.79 | $87.10 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $199.53 | Professional | None | $61.66 | $107.15 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $851.14 | Professional | None | $660.69 | $660.69 | $851.14 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $125.89 | Professional | None | $75.86 | $75.86 | $125.89 |
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 $57.54 Median $109.65 Typical High $229.09 | Facility | None | $57.54 | $109.65 | $229.09 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $131.83 | Professional | None | $60.26 | $83.18 | $131.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | None | $199.53 | $199.53 | $281.84 |
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 $48.98 Median $74.13 Typical High $147.91 | Professional | None | $48.98 | $74.13 | $147.91 |
9 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 $28.84 Median $30.90 Typical High $45.71 | Facility | 52 · Reduced service | $28.84 | $30.90 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $18.20 | Facility | 53 · Discontinued | $11.48 | $12.30 | $18.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $13.80 | Facility | 55 · Aftercare only | $8.51 | $9.33 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $9.12 | Facility | 56 · Pre-op care only | $5.75 | $6.17 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $26.92 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.45 Typical High $18.20 | Professional | 53 · Discontinued | $10.72 | $14.45 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.72 Typical High $13.49 | Professional | 55 · Aftercare only | $7.94 | $10.72 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.37 | $7.24 | $8.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $120.23 Typical High $158.49 | Professional | 50 · Both sides | $93.33 | $120.23 | $158.49 |
Where California sits
The same service costs 3.7 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· 41st of 51
$83.18
AK $257KY $69.18
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.