How much rates vary
Facilitymedian $81 · 10th to 90th $68 to $145Professionalmedian $78 · 10th to 90th $62 to $174
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 $61.66 Median $75.86 Typical High $83.18 | Facility | None | $61.66 | $75.86 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $109.65 | Professional | None | $61.66 | $79.43 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $128.82 | Professional | None | $54.95 | $66.07 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $371.54 | Facility | None | $70.79 | $91.20 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $218.78 | Professional | None | $64.57 | $75.86 | $218.78 |
Blue Shield Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $138.04 | Professional | None | $45.71 | $67.61 | $138.04 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $87.10 | Professional | None | $52.48 | $79.43 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $158.49 | Professional | None | $66.07 | $74.13 | $158.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.02 Median $79.43 Typical High $95.50 | Professional | None | $38.02 | $79.43 | $95.50 |
HealthNet Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | None | $70.79 | $70.79 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $194.98 | Professional | None | $66.07 | $85.11 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $112.20 Median $457.09 Typical High $457.09 | Professional | None | $112.20 | $457.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Optum Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $363.08 | Professional | None | $79.43 | $83.18 | $363.08 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $134.90 | Facility | None | $74.13 | $93.33 | $134.90 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $173.78 | Professional | None | $66.07 | $74.13 | $173.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $154.88 | Professional | None | $54.95 | $77.62 | $154.88 |
10 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 $30.90 Median $33.88 Typical High $35.48 | Facility | 52 · Reduced service | $30.90 | $33.88 | $35.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $10.72 | Facility | 55 · Aftercare only | $9.33 | $10.23 | $10.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.76 Typical High $7.08 | Facility | 56 · Pre-op care only | $6.17 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $30.90 Typical High $35.48 | Professional | 52 · Reduced service | $28.18 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $10.72 | Professional | 55 · Aftercare only | $8.51 | $9.33 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $7.08 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | 24 · Unrelated visit after surgery | $72.44 | $72.44 | $95.50 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $58.88 Median $69.18 Typical High $102.33 | Professional | 25 · Same-day visit | $58.88 | $69.18 | $102.33 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $54.95 Median $54.95 Typical High $114.82 | Professional | 57 · Decision for surgery | $54.95 | $54.95 | $114.82 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $63.10 Median $74.13 Typical High $91.20 | Professional | GC · Resident with teaching physician | $63.10 | $74.13 | $91.20 |
Where California sits
The same service costs 2.4 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· 32nd of 51
$77.62
AK $155AL $64.57
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.