How much rates vary
Facilitymedian $63 · 10th to 90th $49 to $126Professionalmedian $71 · 10th to 90th $45 to $105
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 $70.79 Typical High $107.15 | Facility | None | $45.71 | $70.79 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $97.72 | Professional | None | $43.65 | $70.79 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $87.10 | Professional | None | $63.10 | $70.79 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $309.03 | Facility | None | $52.48 | $66.07 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $83.18 | Professional | None | $52.48 | $67.61 | $83.18 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $89.13 | Facility | None | $64.57 | $83.18 | $89.13 |
Blue Shield Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $91.20 | Professional | None | $54.95 | $79.43 | $91.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $104.71 | Professional | None | $51.29 | $51.29 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $181.97 | Facility | None | $125.89 | $151.36 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $93.33 | Professional | None | $46.77 | $67.61 | $93.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $102.33 | Professional | None | $34.67 | $50.12 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $117.49 | Professional | None | $41.69 | $74.13 | $117.49 |
Lucent Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $102.33 | Professional | None | $38.02 | $46.77 | $102.33 |
Optum Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $87.10 | Professional | None | $72.44 | $75.86 | $87.10 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $93.33 Typical High $151.36 | Facility | None | $50.12 | $93.33 | $151.36 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $89.13 | Professional | None | $46.77 | $67.61 | $89.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $38.02 Median $75.86 Typical High $199.53 | Professional | None | $38.02 | $75.86 | $199.53 |
United Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $63.10 | Facility | None | $48.98 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $102.33 | Professional | None | $38.90 | $61.66 | $102.33 |
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 $21.88 Median $29.51 Typical High $38.90 | Facility | 52 · Reduced service | $21.88 | $29.51 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $8.91 Typical High $11.75 | Facility | 55 · Aftercare only | $6.61 | $8.91 | $11.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.89 Typical High $7.94 | Facility | 56 · Pre-op care only | $4.37 | $5.89 | $7.94 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $42.66 Median $72.44 Typical High $83.18 | Facility | TD · Registered nurse | $42.66 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $27.54 Typical High $35.48 | Professional | 52 · Reduced service | $21.88 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.32 Typical High $10.72 | Professional | 55 · Aftercare only | $6.61 | $8.32 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.50 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.37 | $5.50 | $7.08 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $63.10 Median $74.13 Typical High $83.18 | Professional | 25 · Same-day visit | $63.10 | $74.13 | $83.18 |
Where California sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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
$70.79
AK $107NJ $48.98
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.