How much rates vary
Facilitymedian $102 · 10th to 90th $79 to $195Professionalmedian $110 · 10th to 90th $81 to $234
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 $72.44 Median $89.13 Typical High $114.82 | Facility | None | $72.44 | $89.13 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $169.82 | Professional | None | $79.43 | $107.15 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $107.15 Typical High $436.52 | Facility | None | $83.18 | $107.15 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $281.84 | Professional | None | $85.11 | $89.13 | $281.84 |
Blue Shield Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $295.12 | Professional | None | $67.61 | $107.15 | $295.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $181.97 | Professional | None | $64.57 | $109.65 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $245.47 | Professional | None | $89.13 | $128.82 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $177.83 | Professional | None | $134.90 | $147.91 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $371.54 | Professional | None | $120.23 | $154.88 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $186.21 | Professional | None | $112.20 | $112.20 | $186.21 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $186.21 | Facility | None | $97.72 | $147.91 | $186.21 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $213.80 | Professional | None | $89.13 | $128.82 | $213.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
United Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $446.68 | Professional | None | $79.43 | $123.03 | $446.68 |
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 $36.31 Median $38.90 Typical High $41.69 | Facility | 52 · Reduced service | $36.31 | $38.90 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $11.75 Typical High $12.59 | Facility | 55 · Aftercare only | $10.72 | $11.75 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.76 Typical High $8.32 | Facility | 56 · Pre-op care only | $7.24 | $7.76 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $38.90 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $38.90 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.75 Typical High $17.38 | Professional | 55 · Aftercare only | $10.72 | $11.75 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.76 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.24 | $7.76 | $11.48 |
Where California sits
The same service costs 2.9 times more in Alaska than in Ohio. 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· 29th of 51
$110
AK $224OH $77.62
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.