How much rates vary
Facilitymedian $186 · 10th to 90th $69 to $447Professionalmedian $98 · 10th to 90th $54 to $589
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 $77.62 Median $89.13 Typical High $467.74 | Facility | None | $77.62 | $89.13 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $89.13 | Professional | None | $77.62 | $83.18 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $758.58 Typical High $776.25 | Facility | None | $60.26 | $758.58 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $416.87 | Professional | None | $58.88 | $79.43 | $416.87 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $281.84 Typical High $457.09 | Facility | None | $91.20 | $281.84 | $457.09 |
Blue Shield Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $257.04 | Professional | None | $69.18 | $100.00 | $257.04 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $91.20 | Professional | None | $66.07 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $114.82 Typical High $281.84 | Facility | None | $63.10 | $114.82 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $158.49 | Professional | None | $47.86 | $53.70 | $158.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $131.83 | Professional | None | $83.18 | $112.20 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $218.78 | Professional | None | $75.86 | $102.33 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $794.33 | Professional | None | $588.84 | $794.33 | $794.33 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $269.15 | Facility | None | $74.13 | $117.49 | $269.15 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $181.97 | Professional | None | $47.86 | $53.70 | $181.97 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $426.58 | Facility | None | $281.84 | $281.84 | $426.58 |
United Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $426.58 | Professional | None | $56.23 | $93.33 | $426.58 |
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 $38.90 Median $44.67 Typical High $234.42 | Facility | 52 · Reduced service | $38.90 | $44.67 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $17.78 Typical High $93.33 | Facility | 53 · Discontinued | $15.49 | $17.78 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $13.18 Typical High $70.79 | Facility | 55 · Aftercare only | $11.48 | $13.18 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.91 Typical High $46.77 | Facility | 56 · Pre-op care only | $7.76 | $8.91 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $38.90 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $15.49 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.30 Typical High $13.18 | Professional | 55 · Aftercare only | $11.48 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.91 |
Where California sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 26th of 51
$100
AK $269AL $53.70
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.