How much rates vary
Facilitymedian $95 · 10th to 90th $21 to $347Professionalmedian $58 · 10th to 90th $19 to $263
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 $21.38 Median $23.99 Typical High $83.18 | Facility | None | $21.38 | $23.99 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $47.86 Typical High $83.18 | Professional | None | $21.38 | $47.86 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $25.12 Typical High $102.33 | Facility | None | $19.95 | $25.12 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $57.54 Typical High $70.79 | Professional | None | $20.42 | $57.54 | $70.79 |
Blue Shield Setting Facility Modifier None Typical Low $87.10 Median $263.03 Typical High $407.38 | Facility | None | $87.10 | $263.03 | $407.38 |
Blue Shield Setting Professional Modifier None Typical Low $15.49 Median $36.31 Typical High $58.88 | Professional | None | $15.49 | $36.31 | $58.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $120.23 | Professional | None | $22.39 | $22.39 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $53.70 Typical High $85.11 | Professional | None | $18.62 | $53.70 | $85.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.95 Median $36.31 Typical High $117.49 | Professional | None | $19.95 | $36.31 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $56.23 Typical High $144.54 | Professional | None | $16.98 | $56.23 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $676.08 | Professional | None | $524.81 | $676.08 | $676.08 |
Providence Setting Facility Modifier None Typical Low $22.39 Median $60.26 Typical High $120.23 | Facility | None | $22.39 | $60.26 | $120.23 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $53.70 Typical High $79.43 | Professional | None | $18.62 | $53.70 | $79.43 |
Sutter Health Plus Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $263.03 | Professional | None | $70.79 | $70.79 | $263.03 |
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 $16.98 Median $50.12 Typical High $89.13 | Professional | None | $16.98 | $50.12 | $89.13 |
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 $10.72 Median $12.02 Typical High $41.69 | Facility | 52 · Reduced service | $10.72 | $12.02 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.27 Median $4.79 Typical High $16.60 | Facility | 53 · Discontinued | $4.27 | $4.79 | $16.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.24 Median $3.63 Typical High $12.59 | Facility | 55 · Aftercare only | $3.24 | $3.63 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.40 Typical High $8.32 | Facility | 56 · Pre-op care only | $2.14 | $2.40 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $23.99 Typical High $41.69 | Professional | 52 · Reduced service | $10.72 | $23.99 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $9.55 Typical High $16.60 | Professional | 53 · Discontinued | $4.27 | $9.55 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $7.08 Typical High $12.59 | Professional | 55 · Aftercare only | $3.24 | $7.08 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $4.79 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.14 | $4.79 | $8.32 |
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 4.4 times more in Hawaii 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· 18th of 51
$57.54
HI $110DC $25.12
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.