How much rates vary
Facilitymedian $151 · 10th to 90th $66 to $575Professionalmedian $89 · 10th to 90th $50 to $214
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 $72.44 Median $114.82 Typical High $128.82 | Facility | None | $72.44 | $114.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $154.88 | Professional | None | $72.44 | $109.65 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $128.82 | Professional | None | $102.33 | $114.82 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $338.84 | Facility | None | $66.07 | $83.18 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $173.78 | Professional | None | $50.12 | $85.11 | $173.78 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $398.11 Typical High $676.08 | Facility | None | $100.00 | $398.11 | $676.08 |
Blue Shield Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $100.00 | Professional | None | $40.74 | $56.23 | $100.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $181.97 | Professional | None | $79.43 | $79.43 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $83.18 Typical High $131.83 | Professional | None | $50.12 | $83.18 | $131.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.02 Median $77.62 Typical High $177.83 | Professional | None | $38.02 | $77.62 | $177.83 |
HealthNet Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | None | $128.82 | $186.21 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $134.90 Typical High $245.47 | Professional | None | $64.57 | $134.90 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | None | $794.33 | $794.33 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $104.71 Typical High $724.44 | Professional | None | $48.98 | $104.71 | $724.44 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $194.98 | Facility | None | $72.44 | $114.82 | $194.98 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $131.83 | Professional | None | $66.07 | $100.00 | $131.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $416.87 | Professional | None | $257.04 | $257.04 | $416.87 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $338.84 | Facility | None | $218.78 | $218.78 | $338.84 |
United Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $158.49 | Professional | None | $56.23 | $79.43 | $158.49 |
9 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 Facility Modifier 52 · Reduced service Typical Low $36.31 Median $40.74 Typical High $64.57 | Facility | 52 · Reduced service | $36.31 | $40.74 | $64.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $12.02 Typical High $19.50 | Facility | 55 · Aftercare only | $10.96 | $12.02 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.13 Typical High $12.88 | Facility | 56 · Pre-op care only | $7.24 | $8.13 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $36.31 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.80 Typical High $19.50 | Professional | 55 · Aftercare only | $10.96 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.12 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.24 | $9.12 | $12.88 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 24 · Unrelated visit after surgery | $107.15 | $107.15 | $107.15 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 25 · Same-day visit | $107.15 | $128.82 | $128.82 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 59 · Distinct service | $114.82 | $114.82 | $114.82 |
Where California sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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
$89.13
AK $263NC $61.66
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.