How much rates vary
Facilitymedian $347 · 10th to 90th $55 to $4,169Professionalmedian $59 · 10th to 90th $41 to $200
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 $40.74 Median $43.65 Typical High $64.57 | Facility | None | $40.74 | $43.65 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $109.65 | Professional | None | $40.74 | $58.88 | $109.65 |
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 $44.67 Median $45.71 Typical High $134.90 | Professional | None | $44.67 | $45.71 | $134.90 |
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 $35.48 Median $52.48 Typical High $85.11 | Professional | None | $35.48 | $52.48 | $85.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $93.33 | Professional | None | $34.67 | $47.86 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $131.83 | Facility | None | $50.12 | $64.57 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $95.50 | Professional | None | $44.67 | $61.66 | $95.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $28.18 Median $46.77 Typical High $91.20 | Professional | None | $28.18 | $46.77 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $131.83 | Professional | None | $39.81 | $70.79 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $575.44 | Professional | None | $467.74 | $467.74 | $575.44 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $93.33 | Professional | None | $56.23 | $56.23 | $93.33 |
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 $47.86 Median $64.57 Typical High $128.82 | Facility | None | $47.86 | $64.57 | $128.82 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $93.33 | Professional | None | $42.66 | $60.26 | $93.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $199.53 | Professional | None | $141.25 | $141.25 | $199.53 |
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 $54.95 Typical High $104.71 | Professional | None | $35.48 | $54.95 | $104.71 |
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 $20.42 Median $21.88 Typical High $32.36 | Facility | 52 · Reduced service | $20.42 | $21.88 | $32.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $8.71 Typical High $12.88 | Facility | 53 · Discontinued | $8.13 | $8.71 | $12.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $6.46 Typical High $9.77 | Facility | 55 · Aftercare only | $6.17 | $6.46 | $9.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.37 Typical High $6.46 | Facility | 56 · Pre-op care only | $4.07 | $4.37 | $6.46 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $26.30 Typical High $32.36 | Professional | 52 · Reduced service | $19.50 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $10.47 Typical High $12.88 | Professional | 53 · Discontinued | $7.76 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.76 Typical High $9.77 | Professional | 55 · Aftercare only | $5.89 | $7.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.25 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.89 | $5.25 | $6.46 |
Where California sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 43rd of 51
$58.88
AK $182FL $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.