How much rates vary
Facilitymedian $50 · 10th to 90th $37 to $126Professionalmedian $46 · 10th to 90th $35 to $132
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 $34.67 Median $42.66 Typical High $75.86 | Facility | None | $34.67 | $42.66 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $89.13 | Professional | None | $33.88 | $56.23 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $58.88 | Professional | None | $34.67 | $40.74 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $50.12 Typical High $204.17 | Facility | None | $38.90 | $50.12 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $134.90 | Professional | None | $39.81 | $42.66 | $134.90 |
Blue Shield Setting Professional Modifier None Typical Low $26.92 Median $39.81 Typical High $79.43 | Professional | None | $26.92 | $39.81 | $79.43 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $54.95 | Professional | None | $38.90 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $95.50 | Professional | None | $36.31 | $40.74 | $95.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $27.54 Median $48.98 Typical High $58.88 | Professional | None | $27.54 | $48.98 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $123.03 | Professional | None | $41.69 | $52.48 | $123.03 |
Lucent Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Optum Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $302.00 | Professional | None | $44.67 | $52.48 | $302.00 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $72.44 Typical High $107.15 | Facility | None | $45.71 | $72.44 | $107.15 |
Providence Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $100.00 | Professional | None | $36.31 | $40.74 | $100.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $93.33 | Professional | None | $30.20 | $42.66 | $93.33 |
6 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 $16.98 Median $18.62 Typical High $19.50 | Facility | 52 · Reduced service | $16.98 | $18.62 | $19.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.13 Median $5.62 Typical High $5.89 | Facility | 55 · Aftercare only | $5.13 | $5.62 | $5.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.72 Typical High $3.98 | Facility | 56 · Pre-op care only | $3.47 | $3.72 | $3.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $16.98 Typical High $19.50 | Professional | 52 · Reduced service | $15.85 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.13 Typical High $5.89 | Professional | 55 · Aftercare only | $4.68 | $5.13 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.47 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.16 | $3.47 | $3.98 |
Where California sits
The same service costs 2.7 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· 40th of 51
$45.71
AK $100NJ $37.15
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.