How much rates vary
Facilitymedian $49 · 10th to 90th $31 to $145Professionalmedian $44 · 10th to 90th $24 to $71
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 $24.55 Median $41.69 Typical High $69.18 | Facility | None | $24.55 | $41.69 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $42.66 Typical High $66.07 | Professional | None | $24.55 | $42.66 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $66.07 | Professional | None | $48.98 | $56.23 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $36.31 Typical High $169.82 | Facility | None | $28.84 | $36.31 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $39.81 Typical High $53.70 | Professional | None | $28.84 | $39.81 | $53.70 |
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 $31.62 Median $45.71 Typical High $56.23 | Professional | None | $31.62 | $45.71 | $56.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $83.18 | Professional | None | $31.62 | $38.02 | $83.18 |
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 $23.44 Median $39.81 Typical High $63.10 | Professional | None | $23.44 | $39.81 | $63.10 |
Contra Costa Health Setting Professional Modifier None Typical Low $18.20 Median $38.02 Typical High $81.28 | Professional | None | $18.20 | $38.02 | $81.28 |
HealthNet Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $158.49 | Professional | None | $50.12 | $79.43 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $58.88 Typical High $93.33 | Professional | None | $30.90 | $58.88 | $93.33 |
Lucent Health Setting Professional Modifier None Typical Low $102.33 Median $354.81 Typical High $354.81 | Professional | None | $102.33 | $354.81 | $354.81 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $44.67 Typical High $724.44 | Professional | None | $19.95 | $44.67 | $724.44 |
Optum Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $81.28 | Professional | None | $53.70 | $60.26 | $81.28 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $66.07 Typical High $151.36 | Facility | None | $32.36 | $66.07 | $151.36 |
Providence Setting Professional Modifier None Typical Low $23.44 Median $39.81 Typical High $61.66 | Professional | None | $23.44 | $39.81 | $61.66 |
Sutter Health Plus Setting Professional Modifier None Typical Low $25.70 Median $66.07 Typical High $120.23 | Professional | None | $25.70 | $66.07 | $120.23 |
United Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $20.42 Median $37.15 Typical High $74.13 | Professional | None | $20.42 | $37.15 | $74.13 |
12 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 $11.22 Median $17.38 Typical High $23.44 | Facility | 52 · Reduced service | $11.22 | $17.38 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.39 Median $5.25 Typical High $7.08 | Facility | 55 · Aftercare only | $3.39 | $5.25 | $7.08 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.47 Typical High $4.68 | Facility | 56 · Pre-op care only | $2.24 | $3.47 | $4.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $17.38 Typical High $23.44 | Professional | 52 · Reduced service | $11.22 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $5.25 Typical High $7.08 | Professional | 55 · Aftercare only | $3.39 | $5.25 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.47 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.24 | $3.47 | $4.68 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $42.66 Median $47.86 Typical High $63.10 | Professional | AF · Specialist physician | $42.66 | $47.86 | $63.10 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 24 · Unrelated visit after surgery | $56.23 | $60.26 | $60.26 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $48.98 Median $56.23 Typical High $66.07 | Professional | 25 · Same-day visit | $48.98 | $56.23 | $66.07 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $50.12 Median $58.88 Typical High $69.18 | Professional | 93 · Audio-only telehealth | $50.12 | $58.88 | $69.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $30.90 Median $38.90 Typical High $74.13 | Professional | GC · Resident with teaching physician | $30.90 | $38.90 | $74.13 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | Q6 · Substitute physician, paid per time | $58.88 | $58.88 | $58.88 |
Where California sits
The same service costs 2.4 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· 26th of 51
$43.65
AK $77.62NJ $32.36
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.