How much rates vary
Facilitymedian $363 · 10th to 90th $98 to $4,169Professionalmedian $110 · 10th to 90th $81 to $389
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 $81.28 Median $97.72 Typical High $123.03 | Facility | None | $81.28 | $97.72 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $165.96 | Professional | None | $81.28 | $112.20 | $165.96 |
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 $85.11 Median $87.10 Typical High $269.15 | Professional | None | $85.11 | $87.10 | $269.15 |
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 $67.61 Median $97.72 Typical High $154.88 | Professional | None | $67.61 | $97.72 | $154.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $199.53 | Professional | None | $87.10 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $151.36 Typical High $316.23 | Facility | None | $53.70 | $151.36 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $190.55 | Professional | None | $87.10 | $120.23 | $190.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $194.98 | Professional | None | $95.50 | $117.49 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $323.59 | Professional | None | $85.11 | $147.91 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | None | $107.15 | $107.15 | $177.83 |
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 $61.66 Median $147.91 Typical High $316.23 | Facility | None | $61.66 | $147.91 | $316.23 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $181.97 | Professional | None | $83.18 | $117.49 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $398.11 | Professional | None | $281.84 | $281.84 | $398.11 |
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 $70.79 Median $104.71 Typical High $208.93 | Professional | None | $70.79 | $104.71 | $208.93 |
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 $40.74 Median $43.65 Typical High $61.66 | Facility | 52 · Reduced service | $40.74 | $43.65 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $17.38 Typical High $24.55 | Facility | 53 · Discontinued | $16.22 | $17.38 | $24.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $13.18 Typical High $18.62 | Facility | 55 · Aftercare only | $12.02 | $13.18 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $12.30 | Facility | 56 · Pre-op care only | $8.13 | $8.71 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $48.98 Typical High $61.66 | Professional | 52 · Reduced service | $38.02 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $15.14 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $18.62 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.77 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.59 | $9.77 | $12.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $165.96 Typical High $229.09 | Professional | 50 · Both sides | $131.83 | $165.96 | $229.09 |
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· 44th of 51
$112
AK $355KY $97.72
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.