How much rates vary
Facilitymedian $87 · 10th to 90th $66 to $219Professionalmedian $78 · 10th to 90th $60 to $135
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 $66.07 Median $74.13 Typical High $87.10 | Facility | None | $66.07 | $74.13 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $87.10 | Professional | None | $66.07 | $74.13 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $354.81 | Facility | None | $67.61 | $87.10 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $114.82 | Professional | None | $69.18 | $79.43 | $114.82 |
Blue Shield Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $93.33 | Professional | None | $53.70 | $75.86 | $93.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $107.15 | Professional | None | $60.26 | $72.44 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $131.83 | Professional | None | $70.79 | $85.11 | $131.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | None | $34.67 | $34.67 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $407.38 Typical High $831.76 | Professional | None | $120.23 | $407.38 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $660.69 | Professional | None | $512.86 | $660.69 | $660.69 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $112.20 | Professional | None | $38.02 | $67.61 | $112.20 |
Optum Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $70.79 | Professional | None | $30.90 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $141.25 | Facility | None | $66.07 | $107.15 | $141.25 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $131.83 | Professional | None | $70.79 | $83.18 | $131.83 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $138.04 | Professional | None | $54.95 | $72.44 | $138.04 |
8 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 $33.11 Median $37.15 Typical High $43.65 | Facility | 52 · Reduced service | $33.11 | $37.15 | $43.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $14.79 Typical High $17.38 | Facility | 53 · Discontinued | $13.18 | $14.79 | $17.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $13.18 | Facility | 55 · Aftercare only | $10.00 | $10.96 | $13.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $8.71 | Facility | 56 · Pre-op care only | $6.61 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $37.15 Typical High $43.65 | Professional | 52 · Reduced service | $33.11 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.79 Typical High $17.38 | Professional | 53 · Discontinued | $13.18 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.22 Typical High $13.18 | Professional | 55 · Aftercare only | $10.00 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.61 | $7.41 | $8.71 |
Where California sits
The same service costs 8.1 times more in Alaska than in Indiana. 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· 35th of 51
$77.62
AK $178IN $21.88
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.