How much rates vary
Facilitymedian $52 · 10th to 90th $20 to $195Professionalmedian $22 · 10th to 90th $18 to $151
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 $19.50 Median $21.38 Typical High $21.38 | Facility | None | $19.50 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $22.91 | Professional | None | $18.62 | $19.50 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $21.38 Typical High $23.44 | Facility | None | $19.95 | $21.38 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $21.38 Typical High $60.26 | Professional | None | $19.05 | $21.38 | $60.26 |
Blue Shield Setting Facility Modifier None Typical Low $23.44 Median $60.26 Typical High $147.91 | Facility | None | $23.44 | $60.26 | $147.91 |
Blue Shield Setting Professional Modifier None Typical Low $14.13 Median $20.42 Typical High $30.20 | Professional | None | $14.13 | $20.42 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $169.82 Typical High $1,174.90 | Facility | None | $22.39 | $169.82 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $32.36 Typical High $95.50 | Professional | None | $21.88 | $32.36 | $95.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $27.54 | Professional | None | $20.42 | $22.39 | $27.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $41.69 | Professional | None | $16.98 | $19.05 | $41.69 |
Lucent Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $275.42 | Professional | None | $151.36 | $151.36 | $275.42 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $19.50 Median $30.20 Typical High $169.82 | Facility | None | $19.50 | $30.20 | $169.82 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $34.67 Typical High $95.50 | Professional | None | $21.88 | $34.67 | $95.50 |
Sutter Health Plus Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $549.54 | Facility | None | $354.81 | $354.81 | $549.54 |
United Setting Professional Modifier None Typical Low $16.98 Median $21.88 Typical High $42.66 | Professional | None | $16.98 | $21.88 | $42.66 |
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 $9.33 Median $9.77 Typical High $11.22 | Professional | 52 · Reduced service | $9.33 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.98 Typical High $4.57 | Professional | 53 · Discontinued | $3.72 | $3.98 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.95 Typical High $3.39 | Professional | 55 · Aftercare only | $2.82 | $2.95 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.95 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.86 | $1.95 | $2.29 |
Where California sits
The same service costs 2.8 times more in Alaska than in Florida. 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· 41st of 51
$21.88
AK $54.95FL $19.50
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.