How much rates vary
Facilitymedian $110 · 10th to 90th $46 to $288Professionalmedian $126 · 10th to 90th $43 to $282
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 $45.71 Median $138.04 Typical High $331.13 | Facility | None | $45.71 | $138.04 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $112.20 Typical High $162.18 | Professional | None | $45.71 | $112.20 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Facility | None | $61.66 | $66.07 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $194.98 | Professional | None | $63.10 | $109.65 | $194.98 |
Blue Shield Setting Facility Modifier None Typical Low $41.69 Median $104.71 Typical High $239.88 | Facility | None | $41.69 | $104.71 | $239.88 |
Blue Shield Setting Professional Modifier None Typical Low $38.90 Median $125.89 Typical High $208.93 | Professional | None | $38.90 | $125.89 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $46.77 Median $97.72 Typical High $194.98 | Professional | None | $46.77 | $97.72 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $120.23 Typical High $181.97 | Professional | None | $42.66 | $120.23 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $194.98 | Professional | None | $42.66 | $57.54 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $125.89 Typical High $218.78 | Professional | None | $38.02 | $125.89 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | None | $851.14 | $1,148.15 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | None | $107.15 | $107.15 | $177.83 |
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 $45.71 Median $125.89 Typical High $263.03 | Facility | None | $45.71 | $125.89 | $263.03 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $120.23 Typical High $173.78 | Professional | None | $42.66 | $120.23 | $173.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $426.58 | Professional | None | $151.36 | $151.36 | $426.58 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $537.03 | Facility | None | $346.74 | $346.74 | $537.03 |
United Setting Professional Modifier None Typical Low $36.31 Median $104.71 Typical High $213.80 | Professional | None | $36.31 | $104.71 | $213.80 |
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 $22.91 Median $66.07 Typical High $165.96 | Facility | 52 · Reduced service | $22.91 | $66.07 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $26.30 Typical High $66.07 | Facility | 53 · Discontinued | $9.12 | $26.30 | $66.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $19.95 Typical High $48.98 | Facility | 55 · Aftercare only | $6.76 | $19.95 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $13.18 Typical High $33.11 | Facility | 56 · Pre-op care only | $4.57 | $13.18 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $41.69 Typical High $72.44 | Professional | 52 · Reduced service | $22.91 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $16.60 Typical High $29.51 | Professional | 53 · Discontinued | $9.12 | $16.60 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $12.59 Typical High $21.88 | Professional | 55 · Aftercare only | $6.76 | $12.59 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.32 Typical High $14.79 | Professional | 56 · Pre-op care only | $4.57 | $8.32 | $14.79 |
Where California sits
The same service costs 3.5 times more in Wisconsin 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· 20th of 51
$126
WI $182DC $52.48
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.