How much rates vary
Facilitymedian $1,549 · 10th to 90th $933 to $3,388Professionalmedian $66 · 10th to 90th $49 to $107
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 $1,548.82 Median $1,548.82 Typical High $2,630.27 | Facility | None | $1,548.82 | $1,548.82 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $69.18 | Professional | None | $48.98 | $63.10 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $169.82 Typical High $169.82 | Professional | None | $67.61 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $3,388.44 | Facility | None | $1,659.59 | $2,344.23 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $128.82 | Professional | None | $51.29 | $85.11 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $3,715.35 | Facility | None | $1,023.29 | $1,122.02 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $107.15 | Professional | None | $48.98 | $54.95 | $107.15 |
Hometown Health Setting Professional Modifier None Typical Low $0.83 Median $61.66 Typical High $117.49 | Professional | None | $0.83 | $61.66 | $117.49 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $1,862.09 | Facility | None | $758.58 | $954.99 | $1,862.09 |
Pacific Source Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Providence Setting Facility Modifier None Typical Low $1,122.02 Median $2,290.87 Typical High $3,715.35 | Facility | None | $1,122.02 | $2,290.87 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $102.33 | Professional | None | $43.65 | $64.57 | $102.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $213.80 | Professional | None | $87.10 | $87.10 | $213.80 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $5,128.61 Typical High $6,456.54 | Facility | None | $1,380.38 | $5,128.61 | $6,456.54 |
United Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $95.50 | Professional | None | $54.95 | $67.61 | $95.50 |
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 Professional Modifier 52 · Reduced service Typical Low $29.51 Median $31.62 Typical High $33.88 | Professional | 52 · Reduced service | $29.51 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.55 Typical High $10.00 | Professional | 55 · Aftercare only | $8.91 | $9.55 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $6.76 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $57.54 Median $169.82 Typical High $169.82 | Professional | 25 · Same-day visit | $57.54 | $169.82 | $169.82 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | GC · Resident with teaching physician | $67.61 | $67.61 | $67.61 |
Moda Health Setting Facility Modifier 25 · Same-day visit Typical Low $501.19 Median $977.24 Typical High $2,238.72 | Facility | 25 · Same-day visit | $501.19 | $977.24 | $2,238.72 |
Where Nevada sits
The same service costs 11.2 times more in California than in Idaho. 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.
Physician feeFacility fee
CA $2,527ID $226
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.