How much rates vary
Facilitymedian $170 · 10th to 90th $100 to $479Professionalmedian $129 · 10th to 90th $102 to $282
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 $117.49 Median $128.82 Typical High $128.82 | Facility | None | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $165.96 | Professional | None | $112.20 | $128.82 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $660.69 | Facility | None | $125.89 | $158.49 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $218.78 | Professional | None | $117.49 | $128.82 | $218.78 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $245.47 Typical High $478.63 | Facility | None | $100.00 | $245.47 | $478.63 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $158.49 | Professional | None | $91.20 | $131.83 | $158.49 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | None | $131.83 | $131.83 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $194.98 | Professional | None | $112.20 | $125.89 | $194.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | None | $107.15 | $117.49 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $245.47 | Professional | None | $100.00 | $112.20 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $177.83 Typical High $295.12 | Facility | None | $117.49 | $177.83 | $295.12 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $181.97 | Professional | None | $112.20 | $125.89 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $194.98 | Professional | None | $95.50 | $117.49 | $194.98 |
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 $56.23 Median $58.88 Typical High $64.57 | Professional | 52 · Reduced service | $56.23 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $22.39 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $13.18 |
Where California sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 37th of 51
$129
AK $316UT $97.72
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.