How much rates vary
Facilitymedian $355 · 10th to 90th $89 to $3,311Professionalmedian $60 · 10th to 90th $38 to $148
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 $64.57 Typical High $128.82 | Facility | None | $39.81 | $64.57 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $64.57 Typical High $109.65 | Professional | None | $39.81 | $64.57 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | None | $89.13 | $89.13 | $117.49 |
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 $41.69 Median $42.66 Typical High $128.82 | Professional | None | $41.69 | $42.66 | $128.82 |
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 $30.90 Median $52.48 Typical High $89.13 | Professional | None | $30.90 | $52.48 | $89.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $114.82 | Professional | None | $45.71 | $79.43 | $114.82 |
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 $39.81 Median $61.66 Typical High $102.33 | Professional | None | $39.81 | $61.66 | $102.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $114.82 | Professional | None | $50.12 | $60.26 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $158.49 | Professional | None | $43.65 | $85.11 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $691.83 | Professional | None | $501.19 | $501.19 | $691.83 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $95.50 | Professional | None | $57.54 | $57.54 | $95.50 |
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 $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $100.00 | Professional | None | $39.81 | $61.66 | $100.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $208.93 | Professional | None | $128.82 | $128.82 | $208.93 |
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 $31.62 Median $56.23 Typical High $109.65 | Professional | None | $31.62 | $56.23 | $109.65 |
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 $19.95 Median $21.38 Typical High $35.48 | Facility | 52 · Reduced service | $19.95 | $21.38 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.94 Median $8.51 Typical High $14.13 | Facility | 53 · Discontinued | $7.94 | $8.51 | $14.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.89 Median $6.31 Typical High $10.72 | Facility | 55 · Aftercare only | $5.89 | $6.31 | $10.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.27 Typical High $7.08 | Facility | 56 · Pre-op care only | $3.98 | $4.27 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $27.54 Typical High $33.88 | Professional | 52 · Reduced service | $18.62 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $10.96 Typical High $13.49 | Professional | 53 · Discontinued | $7.41 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.32 Typical High $10.00 | Professional | 55 · Aftercare only | $5.62 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.50 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.72 | $5.50 | $6.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $60.26 Median $85.11 Typical High $107.15 | Professional | 50 · Both sides | $60.26 | $85.11 | $107.15 |
Where California sits
The same service costs 4.0 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· 33rd of 51
$64.57
AK $195KY $48.98
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.