How much rates vary
Facilitymedian $355 · 10th to 90th $38 to $4,169Professionalmedian $42 · 10th to 90th $29 to $191
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 $28.84 Median $30.20 Typical High $48.98 | Facility | None | $28.84 | $30.20 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $38.90 Typical High $44.67 | Professional | None | $27.54 | $38.90 | $44.67 |
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 $33.88 Median $34.67 Typical High $100.00 | Professional | None | $33.88 | $34.67 | $100.00 |
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 $26.30 Median $41.69 Typical High $67.61 | Professional | None | $26.30 | $41.69 | $67.61 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $32.36 Median $60.26 Typical High $85.11 | Professional | None | $32.36 | $60.26 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $45.71 Typical High $79.43 | Facility | None | $30.90 | $45.71 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $67.61 | Professional | None | $28.84 | $44.67 | $67.61 |
Contra Costa Health Setting Professional Modifier None Typical Low $28.84 Median $50.12 Typical High $64.57 | Professional | None | $28.84 | $50.12 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.30 Median $46.77 Typical High $100.00 | Professional | None | $26.30 | $46.77 | $100.00 |
Lucent Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | None | $323.59 | $323.59 | $371.54 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $61.66 | Professional | None | $37.15 | $37.15 | $61.66 |
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 $30.90 Median $46.77 Typical High $79.43 | Facility | None | $30.90 | $46.77 | $79.43 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $67.61 | Professional | None | $28.84 | $44.67 | $67.61 |
Sutter Health Plus Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $141.25 | Professional | None | $93.33 | $93.33 | $141.25 |
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 $23.44 Median $39.81 Typical High $70.79 | Professional | None | $23.44 | $39.81 | $70.79 |
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 $14.45 Median $15.14 Typical High $24.55 | Facility | 52 · Reduced service | $14.45 | $15.14 | $24.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $6.03 Typical High $9.77 | Facility | 53 · Discontinued | $5.75 | $6.03 | $9.77 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $4.47 Typical High $7.24 | Facility | 55 · Aftercare only | $4.27 | $4.47 | $7.24 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.02 Typical High $4.90 | Facility | 56 · Pre-op care only | $2.88 | $3.02 | $4.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $19.05 Typical High $22.39 | Professional | 52 · Reduced service | $13.80 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $7.76 Typical High $8.91 | Professional | 53 · Discontinued | $5.50 | $7.76 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $5.75 Typical High $6.61 | Professional | 55 · Aftercare only | $4.07 | $5.75 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.89 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.75 | $3.89 | $4.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $44.67 Median $56.23 Typical High $77.62 | Professional | 50 · Both sides | $44.67 | $56.23 | $77.62 |
Where California sits
The same service costs 3.3 times more in Alaska than in Virginia. 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
$43.65
AK $112VA $33.88
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.