How much rates vary
Facilitymedian $4,467 · 10th to 90th $240 to $13,490Professionalmedian $174 · 10th to 90th $44 to $407
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 $57.54 Median $6,606.93 Typical High $18,197.01 | Facility | None | $57.54 | $6,606.93 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $117.49 Typical High $316.23 | Professional | None | $44.67 | $117.49 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $251.19 | Professional | None | $61.66 | $79.43 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,456.54 Typical High $14,125.38 | Facility | None | $2,884.03 | $6,456.54 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $173.78 Typical High $363.08 | Professional | None | $50.12 | $173.78 | $363.08 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $33.11 Median $131.83 Typical High $245.47 | Professional | None | $33.11 | $131.83 | $245.47 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $45.71 Median $316.23 Typical High $436.52 | Professional | None | $45.71 | $316.23 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $162.18 Typical High $338.84 | Professional | None | $44.67 | $162.18 | $338.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $40.74 Median $257.04 Typical High $323.59 | Professional | None | $40.74 | $257.04 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $177.83 Typical High $363.08 | Professional | None | $37.15 | $177.83 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $169.82 Typical High $288.40 | Professional | None | $33.11 | $169.82 | $288.40 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $223.87 Typical High $436.52 | Facility | None | $46.77 | $223.87 | $436.52 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $165.96 Typical High $346.74 | Professional | None | $44.67 | $165.96 | $346.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $691.83 | Professional | None | $144.54 | $144.54 | $691.83 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $7,244.36 | Facility | None | $602.56 | $1,698.24 | $7,244.36 |
United Setting Professional Modifier None Typical Low $38.02 Median $169.82 Typical High $371.54 | Professional | None | $38.02 | $169.82 | $371.54 |
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 $23.44 Median $23.99 Typical High $125.89 | Facility | 52 · Reduced service | $23.44 | $23.99 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $50.12 | Facility | 53 · Discontinued | $9.33 | $9.77 | $50.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.24 Typical High $37.15 | Facility | 55 · Aftercare only | $7.08 | $7.24 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.79 Typical High $25.12 | Facility | 56 · Pre-op care only | $4.68 | $4.79 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $72.44 Typical High $125.89 | Professional | 52 · Reduced service | $22.39 | $72.44 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $29.51 Typical High $50.12 | Professional | 53 · Discontinued | $8.91 | $29.51 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $21.88 Typical High $37.15 | Professional | 55 · Aftercare only | $6.76 | $21.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $14.79 Typical High $25.12 | Professional | 56 · Pre-op care only | $4.47 | $14.79 | $25.12 |
Where California sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 30th of 51
$178
NC $309HI $58.88
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.