How much rates vary
Facilitymedian $229 · 10th to 90th $52 to $1,660Professionalmedian $72 · 10th to 90th $48 to $275
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 $46.77 Median $47.86 Typical High $67.61 | Facility | None | $46.77 | $47.86 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $93.33 | Professional | None | $46.77 | $66.07 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $3,890.45 | Facility | None | $52.48 | $69.18 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $213.80 | Professional | None | $52.48 | $74.13 | $213.80 |
Blue Shield Setting Facility Modifier None Typical Low $85.11 Median $416.87 Typical High $1,479.11 | Facility | None | $85.11 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $69.18 Typical High $154.88 | Professional | None | $39.81 | $69.18 | $154.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $97.72 | Professional | None | $38.02 | $48.98 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $128.82 | Facility | None | $48.98 | $63.10 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $134.90 | Professional | None | $47.86 | $66.07 | $134.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $97.72 | Professional | None | $38.02 | $47.86 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $162.18 | Professional | None | $41.69 | $79.43 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | None | $549.54 | $549.54 | $630.96 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $109.65 | Professional | None | $66.07 | $66.07 | $109.65 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $66.07 Typical High $128.82 | Facility | None | $48.98 | $66.07 | $128.82 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $134.90 | Professional | None | $47.86 | $63.10 | $134.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | None | $154.88 | $154.88 | $229.09 |
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 $39.81 Median $67.61 Typical High $165.96 | Professional | None | $39.81 | $67.61 | $165.96 |
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 $33.88 | Facility | 52 · Reduced service | $23.44 | $23.99 | $33.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $9.55 Typical High $13.49 | Facility | 53 · Discontinued | $9.33 | $9.55 | $13.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $7.08 Typical High $10.00 | Facility | 55 · Aftercare only | $6.92 | $7.08 | $10.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.79 Typical High $6.76 | Facility | 56 · Pre-op care only | $4.68 | $4.79 | $6.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $29.51 Typical High $33.88 | Professional | 52 · Reduced service | $21.88 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.75 Typical High $13.49 | Professional | 53 · Discontinued | $8.71 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.71 Typical High $10.00 | Professional | 55 · Aftercare only | $6.61 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.89 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.37 | $5.89 | $6.76 |
Where California sits
The same service costs 3.1 times more in Wisconsin 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· 38th of 51
$74.13
WI $204FL $66.07
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.