How much rates vary
Facilitymedian $95 · 10th to 90th $76 to $191Professionalmedian $100 · 10th to 90th $76 to $178
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 $75.86 Median $75.86 Typical High $91.20 | Facility | None | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $134.90 | Professional | None | $75.86 | $87.10 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $346.74 | Professional | None | $75.86 | $75.86 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $117.49 | Facility | None | $81.28 | $104.71 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $181.97 | Professional | None | $69.18 | $100.00 | $181.97 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $85.11 Typical High $107.15 | Facility | None | $70.79 | $85.11 | $107.15 |
Blue Shield Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $204.17 | Professional | None | $75.86 | $91.20 | $204.17 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $114.82 | Professional | None | $67.61 | $83.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $144.54 Typical High $234.42 | Facility | None | $93.33 | $144.54 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $204.17 | Professional | None | $67.61 | $89.13 | $204.17 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $114.82 Typical High $223.87 | Facility | None | $75.86 | $114.82 | $223.87 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | None | $75.86 | $93.33 | $93.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $204.17 | Professional | None | $95.50 | $102.33 | $204.17 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where California sits
The same service costs 2.9 times more in Arizona 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· 4th of 51
$100
AZ $115AL $39.81
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.