How much rates vary
Facilitymedian $355 · 10th to 90th $83 to $4,169Professionalmedian $85 · 10th to 90th $62 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 $61.66 Median $87.10 Typical High $112.20 | Facility | None | $61.66 | $87.10 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $147.91 | Professional | None | $61.66 | $87.10 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $64.57 Median $64.57 Typical High $199.53 | Professional | None | $64.57 | $64.57 | $199.53 |
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 $47.86 Median $72.44 Typical High $117.49 | Professional | None | $47.86 | $72.44 | $117.49 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $151.36 | Professional | None | $69.18 | $117.49 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $117.49 Typical High $245.47 | Facility | None | $53.70 | $117.49 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $147.91 | Professional | None | $64.57 | $91.20 | $147.91 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $151.36 | Professional | None | $75.86 | $93.33 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $213.80 | Professional | None | $67.61 | $117.49 | $213.80 |
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 $114.82 Typical High $245.47 | Facility | None | $58.88 | $114.82 | $245.47 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $141.25 | Professional | None | $64.57 | $91.20 | $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 $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 $53.70 Median $81.28 Typical High $162.18 | Professional | None | $53.70 | $81.28 | $162.18 |
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 $30.90 Median $33.11 Typical High $47.86 | Facility | 52 · Reduced service | $30.90 | $33.11 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $19.50 | Facility | 53 · Discontinued | $12.30 | $13.18 | $19.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $14.45 | Facility | 55 · Aftercare only | $9.12 | $10.00 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $9.55 | Facility | 56 · Pre-op care only | $6.17 | $6.61 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $38.02 Typical High $47.86 | Professional | 52 · Reduced service | $28.84 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $15.14 Typical High $19.50 | Professional | 53 · Discontinued | $11.48 | $15.14 | $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 $5.75 Median $7.59 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.75 | $7.59 | $9.55 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $128.82 Typical High $173.78 | Professional | 50 · Both sides | $100.00 | $128.82 | $173.78 |
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· 44th of 51
$87.10
AK $275KY $74.13
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.