How much rates vary
Facilitymedian $417 · 10th to 90th $56 to $5,012Professionalmedian $59 · 10th to 90th $21 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 $72.44 Median $4,466.84 Typical High $14,791.08 | Facility | None | $72.44 | $4,466.84 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $66.07 Typical High $141.25 | Professional | None | $22.39 | $66.07 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $114.82 | Professional | None | $87.10 | $102.33 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $22.39 Typical High $3,890.45 | Facility | None | $16.98 | $22.39 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $57.54 Typical High $186.21 | Professional | None | $16.98 | $57.54 | $186.21 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $398.11 Typical High $1,288.25 | Facility | None | $91.20 | $398.11 | $1,288.25 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $89.13 | Professional | None | $39.81 | $56.23 | $89.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $151.36 | Professional | None | $38.02 | $70.79 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $52.48 Typical High $107.15 | Professional | None | $16.60 | $52.48 | $107.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $147.91 | Professional | None | $33.88 | $46.77 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $100.00 Typical High $204.17 | Professional | None | $31.62 | $100.00 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $138.04 | Professional | None | $83.18 | $83.18 | $138.04 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $72.44 Typical High $138.04 | Facility | None | $31.62 | $72.44 | $138.04 |
Providence Setting Professional Modifier None Typical Low $16.60 Median $52.48 Typical High $107.15 | Professional | None | $16.60 | $52.48 | $107.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $323.59 | Professional | None | $120.23 | $120.23 | $323.59 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $30.20 Median $64.57 Typical High $165.96 | Professional | None | $30.20 | $64.57 | $165.96 |
5 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 54 · Surgery only Typical Low $16.60 Median $18.62 Typical High $64.57 | Facility | 54 · Surgery only | $16.60 | $18.62 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $33.88 Typical High $64.57 | Professional | 54 · Surgery only | $16.60 | $33.88 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $6.76 Typical High $12.88 | Professional | 55 · Aftercare only | $3.31 | $6.76 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $4.47 Typical High $8.51 | Professional | 56 · Pre-op care only | $2.19 | $4.47 | $8.51 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | GO · Occupational therapy plan | $89.13 | $89.13 | $89.13 |
Where California sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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· 46th of 51
$61.66
AK $141KY $51.29
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.