How much rates vary
Facilitymedian $132 · 10th to 90th $69 to $234Professionalmedian $155 · 10th to 90th $115 to $229
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 $123.03 Median $158.49 Typical High $239.88 | Facility | None | $123.03 | $158.49 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $208.93 | Professional | None | $112.20 | $154.88 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $199.53 | Professional | None | $114.82 | $165.96 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $549.54 | Facility | None | $134.90 | $169.82 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $186.21 | Professional | None | $134.90 | $151.36 | $186.21 |
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 $114.82 Median $162.18 Typical High $190.55 | Professional | None | $114.82 | $162.18 | $190.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $239.88 | Professional | None | $117.49 | $144.54 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $151.36 Typical High $190.55 | Facility | None | $128.82 | $151.36 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $213.80 | Professional | None | $117.49 | $151.36 | $213.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $69.18 Median $141.25 Typical High $234.42 | Professional | None | $69.18 | $141.25 | $234.42 |
HealthNet Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $426.58 | Professional | None | $194.98 | $199.53 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $275.42 | Professional | None | $117.49 | $177.83 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $218.78 Median $1,047.13 Typical High $1,047.13 | Professional | None | $218.78 | $1,047.13 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $239.88 | Professional | None | $75.86 | $93.33 | $239.88 |
Optum Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $194.98 | Professional | None | $151.36 | $173.78 | $194.98 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $165.96 Typical High $251.19 | Facility | None | $128.82 | $165.96 | $251.19 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $208.93 | Professional | None | $117.49 | $151.36 | $208.93 |
Sutter Health Plus Setting Professional Modifier None Typical Low $75.86 Median $331.13 Typical High $426.58 | Professional | None | $75.86 | $331.13 | $426.58 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $131.83 | Facility | None | $69.18 | $69.18 | $131.83 |
United Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $234.42 | Professional | None | $100.00 | $138.04 | $234.42 |
19 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 $56.23 Median $70.79 Typical High $85.11 | Facility | 52 · Reduced service | $56.23 | $70.79 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $25.70 | Facility | 55 · Aftercare only | $16.98 | $20.89 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $16.98 | Facility | 56 · Pre-op care only | $11.22 | $14.13 | $16.98 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $109.65 Median $154.88 Typical High $177.83 | Facility | TD · Registered nurse | $109.65 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $64.57 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $16.22 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $128.82 Median $173.78 Typical High $218.78 | Professional | AF · Specialist physician | $128.82 | $173.78 | $218.78 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $95.50 Median $128.82 Typical High $165.96 | Professional | HO · Master's level | $95.50 | $128.82 | $165.96 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $109.65 Median $134.90 Typical High $186.21 | Professional | TD · Registered nurse | $109.65 | $134.90 | $186.21 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $144.54 Median $173.78 Typical High $204.17 | Professional | 25 · Same-day visit | $144.54 | $173.78 | $204.17 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 33 · Preventive service | $186.21 | $186.21 | $186.21 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $154.88 Median $223.87 Typical High $223.87 | Professional | 57 · Decision for surgery | $154.88 | $223.87 | $223.87 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 93 · Audio-only telehealth | $165.96 | $165.96 | $173.78 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $109.65 Median $109.65 Typical High $269.15 | Professional | GC · Resident with teaching physician | $109.65 | $109.65 | $269.15 |
Ambetter Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | GQ · Store-and-forward telehealth | $173.78 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | Q6 · Substitute physician, paid per time | $147.91 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | SA · Nurse practitioner | $173.78 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier SC · Medically necessary Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | SC · Medically necessary | $173.78 | $173.78 | $173.78 |
Where California sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 25th of 51
$155
AK $263AL $115
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.