How much rates vary
Facilitymedian $12 · 10th to 90th $10 to $52Professionalmedian $13 · 10th to 90th $10 to $36
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 $10.00 Typical High $18.20 | Facility | None | $10.00 | $10.00 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $13.18 Typical High $26.92 | Professional | None | $10.00 | $13.18 | $26.92 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $14.45 Typical High $85.11 | Professional | None | $12.59 | $14.45 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.77 Median $12.30 Typical High $50.12 | Facility | None | $9.77 | $12.30 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $36.31 | Professional | None | $9.77 | $13.18 | $36.31 |
Blue Shield Setting Facility Modifier None Typical Low $38.02 Median $52.48 Typical High $93.33 | Facility | None | $38.02 | $52.48 | $93.33 |
Blue Shield Setting Professional Modifier None Typical Low $10.00 Median $15.14 Typical High $38.02 | Professional | None | $10.00 | $15.14 | $38.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.75 Median $16.98 Typical High $23.44 | Professional | None | $5.75 | $16.98 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $13.49 Typical High $23.99 | Professional | None | $9.55 | $13.49 | $23.99 |
Contra Costa Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.22 Median $21.88 Typical High $54.95 | Professional | None | $16.22 | $21.88 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $16.98 Median $22.39 Typical High $81.28 | Professional | None | $16.98 | $22.39 | $81.28 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Providence Setting Facility Modifier None Typical Low $10.00 Median $14.45 Typical High $25.70 | Facility | None | $10.00 | $14.45 | $25.70 |
Providence Setting Professional Modifier None Typical Low $9.55 Median $13.49 Typical High $23.99 | Professional | None | $9.55 | $13.49 | $23.99 |
Sutter Health Plus Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $9.55 Median $14.79 Typical High $54.95 | Professional | None | $9.55 | $14.79 | $54.95 |
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 $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
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 $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where California sits
The same service costs 5.6 times more in Alabama than in Kentucky. 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· 32nd of 51
$13.49
AL $56.23KY $10.00
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.