How much rates vary
Facilitymedian $355 · 10th to 90th $79 to $4,169Professionalmedian $66 · 10th to 90th $40 to $316
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 $42.66 Typical High $85.11 | Facility | None | $39.81 | $42.66 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $85.11 | Professional | None | $39.81 | $66.07 | $85.11 |
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 $42.66 Median $43.65 Typical High $147.91 | Professional | None | $42.66 | $43.65 | $147.91 |
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 $33.88 Median $58.88 Typical High $102.33 | Professional | None | $33.88 | $58.88 | $102.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $47.86 Median $117.49 Typical High $154.88 | Professional | None | $47.86 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $114.82 Typical High $239.88 | Facility | None | $53.70 | $114.82 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $72.44 Typical High $131.83 | Professional | None | $43.65 | $72.44 | $131.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $42.66 Median $89.13 Typical High $138.04 | Professional | None | $42.66 | $89.13 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $104.71 Typical High $204.17 | Professional | None | $39.81 | $104.71 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $851.14 | Professional | None | $645.65 | $645.65 | $851.14 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $123.03 | Professional | None | $74.13 | $74.13 | $123.03 |
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 $109.65 Typical High $239.88 | Facility | None | $50.12 | $109.65 | $239.88 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $72.44 Typical High $120.23 | Professional | None | $41.69 | $72.44 | $120.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $275.42 | Professional | None | $141.25 | $141.25 | $275.42 |
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 $35.48 Median $69.18 Typical High $141.25 | Professional | None | $35.48 | $69.18 | $141.25 |
8 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 $20.89 Typical High $42.66 | Facility | 52 · Reduced service | $19.95 | $20.89 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.94 Median $8.51 Typical High $16.98 | Facility | 53 · Discontinued | $7.94 | $8.51 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $6.31 Typical High $12.59 | Facility | 55 · Aftercare only | $6.03 | $6.31 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.27 Typical High $8.51 | Facility | 56 · Pre-op care only | $3.98 | $4.27 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $33.11 Typical High $42.66 | Professional | 52 · Reduced service | $18.62 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $13.18 Typical High $16.98 | Professional | 53 · Discontinued | $7.59 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.00 Typical High $12.59 | Professional | 55 · Aftercare only | $5.62 | $10.00 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.61 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.80 | $6.61 | $8.51 |
Where California sits
The same service costs 3.9 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· 44th of 51
$70.79
AK $204VA $52.48
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.