How much rates vary
Facilitymedian $363 · 10th to 90th $89 to $741Professionalmedian $288 · 10th to 90th $263 to $617
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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $407.38 | Professional | None | $269.15 | $295.12 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $933.25 | Facility | None | $302.00 | $457.09 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $645.65 | Professional | None | $245.47 | $288.40 | $645.65 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $245.47 Typical High $416.87 | Facility | None | $77.62 | $245.47 | $416.87 |
Blue Shield Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $691.83 | Professional | None | $263.03 | $309.03 | $691.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $407.38 | Professional | None | $239.88 | $295.12 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $537.03 Typical High $812.83 | Facility | None | $269.15 | $537.03 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $724.44 | Professional | None | $239.88 | $323.59 | $724.44 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $741.31 | Facility | None | $269.15 | $389.05 | $741.31 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $257.04 | Facility | None | $245.47 | $245.47 | $257.04 |
United Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $645.65 | Professional | None | $269.15 | $288.40 | $645.65 |
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 $134.90 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $26.92 |
Where California sits
The same service costs 2.3 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· 5th of 51
$295
AZ $372AL $162
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.