How much rates vary
Facilitymedian $138 · 10th to 90th $83 to $363Professionalmedian $100 · 10th to 90th $76 to $295
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 $83.18 Median $91.20 Typical High $91.20 | Facility | None | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $93.33 | Professional | None | $79.43 | $83.18 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $125.89 Typical High $512.86 | Facility | None | $100.00 | $125.89 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $173.78 | Professional | None | $83.18 | $102.33 | $173.78 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $218.78 Typical High $338.84 | Facility | None | $70.79 | $218.78 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $125.89 | Professional | None | $72.44 | $104.71 | $125.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | None | $95.50 | $95.50 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $141.25 | Professional | None | $89.13 | $97.72 | $141.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $104.71 | Professional | None | $85.11 | $87.10 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $173.78 | Professional | None | $72.44 | $79.43 | $173.78 |
Lucent Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $83.18 Median $128.82 Typical High $512.86 | Facility | None | $83.18 | $128.82 | $512.86 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $141.25 | Professional | None | $89.13 | $95.50 | $141.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $141.25 | Professional | None | $69.18 | $87.10 | $141.25 |
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 $39.81 Median $41.69 Typical High $46.77 | Professional | 52 · Reduced service | $39.81 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $18.62 | Professional | 53 · Discontinued | $15.85 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $13.80 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $9.33 |
Where California sits
The same service costs 3.1 times more in Alaska than in Florida. 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· 31st of 51
$100
AK $229FL $74.13
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.