How much rates vary
Facilitymedian $195 · 10th to 90th $91 to $776Professionalmedian $107 · 10th to 90th $71 to $490
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 $91.20 Median $275.42 Typical High $630.96 | Facility | None | $91.20 | $275.42 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $104.71 | Professional | None | $75.86 | $91.20 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $562.34 | Facility | None | $107.15 | $138.04 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $158.49 | Professional | None | $75.86 | $109.65 | $158.49 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $501.19 Typical High $912.01 | Facility | None | $100.00 | $501.19 | $912.01 |
Blue Shield Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $138.04 | Professional | None | $69.18 | $97.72 | $138.04 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $36.31 Median $114.82 Typical High $114.82 | Professional | None | $36.31 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $85.11 | Facility | None | $58.88 | $58.88 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $141.25 | Professional | None | $81.28 | $89.13 | $141.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $16.60 Median $102.33 Typical High $112.20 | Professional | None | $16.60 | $102.33 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $194.98 | Professional | None | $79.43 | $91.20 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | None | $489.78 | $660.69 | $660.69 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $58.88 Median $114.82 Typical High $173.78 | Facility | None | $58.88 | $114.82 | $173.78 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $128.82 | Professional | None | $81.28 | $87.10 | $128.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $117.49 | Facility | None | $77.62 | $77.62 | $117.49 |
United Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $138.04 | Professional | None | $60.26 | $83.18 | $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 $45.71 Median $138.04 Typical High $316.23 | Facility | 52 · Reduced service | $45.71 | $138.04 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $56.23 Typical High $125.89 | Facility | 53 · Discontinued | $18.20 | $56.23 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $41.69 Typical High $95.50 | Facility | 55 · Aftercare only | $13.49 | $41.69 | $95.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $27.54 Typical High $63.10 | Facility | 56 · Pre-op care only | $9.12 | $27.54 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $38.02 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $15.14 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $11.48 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.59 | $9.12 | $10.47 |
Where California sits
The same service costs 3.0 times more in Alaska than in Utah. 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· 18th of 51
$107
AK $195UT $64.57
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.