How much rates vary
Facilitymedian $79 · 10th to 90th $34 to $166Professionalmedian $85 · 10th to 90th $29 to $191
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 $31.62 Median $97.72 Typical High $229.09 | Facility | None | $31.62 | $97.72 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $81.28 Typical High $141.25 | Professional | None | $28.84 | $81.28 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $44.67 Typical High $50.12 | Facility | None | $42.66 | $44.67 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $77.62 Typical High $141.25 | Professional | None | $42.66 | $77.62 | $141.25 |
Blue Shield Setting Facility Modifier None Typical Low $36.31 Median $79.43 Typical High $131.83 | Facility | None | $36.31 | $79.43 | $131.83 |
Blue Shield Setting Professional Modifier None Typical Low $27.54 Median $97.72 Typical High $162.18 | Professional | None | $27.54 | $97.72 | $162.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $125.89 | Professional | None | $30.20 | $74.13 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Facility | None | $93.33 | $93.33 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $83.18 Typical High $138.04 | Professional | None | $29.51 | $83.18 | $138.04 |
Contra Costa Health Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $123.03 | Professional | None | $26.92 | $38.90 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $81.28 Typical High $141.25 | Professional | None | $24.55 | $81.28 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | None | $616.60 | $724.44 | $724.44 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $114.82 | Professional | None | $67.61 | $67.61 | $114.82 |
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 $31.62 Median $87.10 Typical High $173.78 | Facility | None | $31.62 | $87.10 | $173.78 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $83.18 Typical High $138.04 | Professional | None | $29.51 | $83.18 | $138.04 |
Sutter Health Plus Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $275.42 | Professional | None | $97.72 | $97.72 | $275.42 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $181.97 | Facility | None | $117.49 | $117.49 | $181.97 |
United Setting Professional Modifier None Typical Low $23.44 Median $70.79 Typical High $177.83 | Professional | None | $23.44 | $70.79 | $177.83 |
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 $15.85 Median $47.86 Typical High $112.20 | Facility | 52 · Reduced service | $15.85 | $47.86 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $19.50 Typical High $45.71 | Facility | 53 · Discontinued | $6.31 | $19.50 | $45.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.68 Median $14.45 Typical High $33.88 | Facility | 55 · Aftercare only | $4.68 | $14.45 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.16 Median $9.55 Typical High $22.91 | Facility | 56 · Pre-op care only | $3.16 | $9.55 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $29.51 Typical High $48.98 | Professional | 52 · Reduced service | $15.85 | $29.51 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $11.75 Typical High $19.95 | Professional | 53 · Discontinued | $6.31 | $11.75 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $8.91 Typical High $14.79 | Professional | 55 · Aftercare only | $4.68 | $8.91 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $5.89 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.16 | $5.89 | $10.00 |
Where California sits
The same service costs 3.6 times more in North Carolina 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· 19th of 51
$85.11
NC $123DC $33.88
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.