How much rates vary
Facilitymedian $34 · 10th to 90th $12 to $148Professionalmedian $27 · 10th to 90th $11 to $55
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 $10.00 Median $12.59 Typical High $169.82 | Facility | None | $10.00 | $12.59 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $38.02 | Professional | None | $10.00 | $13.49 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $22.39 Typical High $53.70 | Professional | None | $12.59 | $22.39 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $33.88 Typical High $138.04 | Facility | None | $26.92 | $33.88 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $26.92 Typical High $74.13 | Professional | None | $15.14 | $26.92 | $74.13 |
Blue Shield Setting Facility Modifier None Typical Low $52.48 Median $79.43 Typical High $208.93 | Facility | None | $52.48 | $79.43 | $208.93 |
Blue Shield Setting Professional Modifier None Typical Low $20.89 Median $30.20 Typical High $61.66 | Professional | None | $20.89 | $30.20 | $61.66 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.47 Median $7.59 Typical High $32.36 | Professional | None | $4.47 | $7.59 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $26.92 Typical High $45.71 | Professional | None | $15.85 | $26.92 | $45.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $30.20 Typical High $77.62 | Professional | None | $22.39 | $30.20 | $77.62 |
Lucent Health Setting Professional Modifier None Typical Low $16.98 Median $38.02 Typical High $114.82 | Professional | None | $16.98 | $38.02 | $114.82 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Providence Setting Facility Modifier None Typical Low $10.00 Median $19.95 Typical High $43.65 | Facility | None | $10.00 | $19.95 | $43.65 |
Providence Setting Professional Modifier None Typical Low $15.85 Median $25.70 Typical High $51.29 | Professional | None | $15.85 | $25.70 | $51.29 |
Sutter Health Plus Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $181.97 | Facility | None | $117.49 | $117.49 | $181.97 |
United Setting Professional Modifier None Typical Low $14.45 Median $23.99 Typical High $70.79 | Professional | None | $14.45 | $23.99 | $70.79 |
4 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 Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.13 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.04 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.02 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.02 |
Where California sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 19th of 51
$26.92
VT $75.86KS $14.13
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.