How much rates vary
Facilitymedian $151 · 10th to 90th $117 to $309Professionalmedian $141 · 10th to 90th $105 to $275
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 $109.65 Median $125.89 Typical High $144.54 | Facility | None | $109.65 | $125.89 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $177.83 | Professional | None | $104.71 | $128.82 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $724.44 | Facility | None | $138.04 | $177.83 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $331.13 | Professional | None | $120.23 | $147.91 | $331.13 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $288.40 | Professional | None | $102.33 | $151.36 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $138.04 | Professional | None | $89.13 | $109.65 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $263.03 | Professional | None | $123.03 | $138.04 | $263.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $131.83 | Professional | None | $74.13 | $97.72 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $257.04 | Professional | None | $87.10 | $104.71 | $257.04 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Optum Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $181.97 | Professional | None | $100.00 | $147.91 | $181.97 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $181.97 Typical High $263.03 | Facility | None | $104.71 | $181.97 | $263.03 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $269.15 | Professional | None | $123.03 | $134.90 | $269.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $251.19 | Professional | None | $97.72 | $125.89 | $251.19 |
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 $58.88 Median $63.10 Typical High $67.61 | Facility | 52 · Reduced service | $58.88 | $63.10 | $67.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $19.05 Typical High $19.95 | Facility | 55 · Aftercare only | $17.38 | $19.05 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $13.49 | Facility | 56 · Pre-op care only | $11.75 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | 52 · Reduced service | $53.70 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $13.49 |
Where California sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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· 16th of 51
$141
AK $209DC $102
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.