How much rates vary
Facilitymedian $129 · 10th to 90th $46 to $427Professionalmedian $79 · 10th to 90th $42 to $331
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 $46.77 Median $52.48 Typical High $109.65 | Facility | None | $46.77 | $52.48 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $112.20 | Professional | None | $46.77 | $79.43 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $53.70 Typical High $218.78 | Facility | None | $42.66 | $53.70 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $69.18 Typical High $100.00 | Professional | None | $43.65 | $69.18 | $100.00 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $309.03 Typical High $512.86 | Facility | None | $97.72 | $309.03 | $512.86 |
Blue Shield Setting Professional Modifier None Typical Low $30.90 Median $52.48 Typical High $83.18 | Professional | None | $30.90 | $52.48 | $83.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $141.25 | Professional | None | $45.71 | $45.71 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $109.65 | Professional | None | $41.69 | $79.43 | $109.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $33.11 Median $44.67 Typical High $138.04 | Professional | None | $33.11 | $44.67 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $87.10 Typical High $194.98 | Professional | None | $33.88 | $87.10 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | None | $645.65 | $812.83 | $812.83 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $134.90 | Professional | None | $81.28 | $81.28 | $134.90 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $97.72 Typical High $204.17 | Facility | None | $48.98 | $97.72 | $204.17 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $107.15 | Professional | None | $41.69 | $79.43 | $107.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $331.13 | Professional | None | $147.91 | $147.91 | $331.13 |
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 $33.11 Median $56.23 Typical High $114.82 | Professional | None | $33.11 | $56.23 | $114.82 |
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 $23.44 Median $26.30 Typical High $54.95 | Facility | 52 · Reduced service | $23.44 | $26.30 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $10.47 Typical High $21.88 | Facility | 53 · Discontinued | $9.33 | $10.47 | $21.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.76 Typical High $16.60 | Facility | 55 · Aftercare only | $7.08 | $7.76 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.25 Typical High $10.96 | Facility | 56 · Pre-op care only | $4.68 | $5.25 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $33.88 Typical High $54.95 | Professional | 52 · Reduced service | $23.44 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.49 Typical High $21.88 | Professional | 53 · Discontinued | $9.33 | $13.49 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.23 Typical High $16.60 | Professional | 55 · Aftercare only | $7.08 | $10.23 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.68 | $6.76 | $10.96 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where California sits
The same service costs 2.5 times more in Alaska than in Washington, DC. 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· 14th of 51
$79.43
AK $129DC $51.29
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.