How much rates vary
Facilitymedian $324 · 10th to 90th $162 to $1,318Professionalmedian $158 · 10th to 90th $91 to $457
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 $173.78 Median $190.55 Typical High $204.17 | Facility | None | $173.78 | $190.55 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $223.87 | Professional | None | $128.82 | $173.78 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $831.76 | Facility | None | $162.18 | $204.17 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $251.19 | Professional | None | $79.43 | $162.18 | $251.19 |
Blue Shield Setting Facility Modifier None Typical Low $194.98 Median $851.14 Typical High $1,548.82 | Facility | None | $194.98 | $851.14 | $1,548.82 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $181.97 | Professional | None | $91.20 | $131.83 | $181.97 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $169.82 | Professional | None | $114.82 | $144.54 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $229.09 | Professional | None | $123.03 | $147.91 | $229.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $181.97 | Professional | None | $95.50 | $144.54 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $263.03 | Professional | None | $102.33 | $134.90 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | None | $794.33 | $1,023.29 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $173.78 | Professional | None | $104.71 | $134.90 | $173.78 |
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 $165.96 Median $239.88 Typical High $302.00 | Facility | None | $165.96 | $239.88 | $302.00 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $223.87 | Professional | None | $123.03 | $144.54 | $223.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $245.47 | Professional | None | $95.50 | $128.82 | $245.47 |
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 $63.10 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $63.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.30 Typical High $30.20 | Professional | 55 · Aftercare only | $19.05 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.38 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $17.38 | $20.42 |
Where California sits
The same service costs 2.8 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· 17th of 51
$162
AK $269IN $95.50
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.