How much rates vary
Facilitymedian $282 · 10th to 90th $219 to $912Professionalmedian $245 · 10th to 90th $204 to $1,905
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 $218.78 Median $245.47 Typical High $245.47 | Facility | None | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $501.19 | Professional | None | $218.78 | $245.47 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | None | $269.15 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $1,174.90 | Facility | None | $223.87 | $281.84 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $436.52 | Professional | None | $229.09 | $229.09 | $436.52 |
Blue Shield Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $275.42 | Professional | None | $158.49 | $229.09 | $275.42 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $407.38 | Professional | None | $302.00 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $380.19 | Professional | None | $234.42 | $251.19 | $380.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $190.55 Median $371.54 Typical High $407.38 | Professional | None | $190.55 | $371.54 | $407.38 |
HealthNet Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $588.84 | Professional | None | $302.00 | $331.13 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,630.27 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $489.78 | Facility | None | $218.78 | $331.13 | $489.78 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $371.54 | Professional | None | $234.42 | $245.47 | $371.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
United Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $398.11 | Professional | None | $181.97 | $251.19 | $398.11 |
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 $104.71 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $104.71 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $41.69 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $24.55 |
Where California sits
The same service costs 2.8 times more in Alaska than in New York. 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· 48th of 51
$245
AK $661NY $234
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.