How much rates vary
Facilitymedian $138 · 10th to 90th $107 to $229Professionalmedian $126 · 10th to 90th $95 to $214
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 $104.71 Median $117.49 Typical High $141.25 | Facility | None | $104.71 | $117.49 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $158.49 | Professional | None | $102.33 | $120.23 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $295.12 | Professional | None | $112.20 | $112.20 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $660.69 | Facility | None | $125.89 | $162.18 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $338.84 | Professional | None | $120.23 | $131.83 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $141.25 | Professional | None | $85.11 | $120.23 | $141.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $64.57 | Professional | None | $51.29 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $239.88 | Professional | None | $104.71 | $128.82 | $239.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $169.82 | Professional | None | $51.29 | $64.57 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $416.87 | Professional | None | $109.65 | $141.25 | $416.87 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $194.98 | Facility | None | $87.10 | $141.25 | $194.98 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $162.18 | Professional | None | $107.15 | $125.89 | $162.18 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $537.03 | Professional | None | $97.72 | $120.23 | $537.03 |
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 $54.95 Median $58.88 Typical High $63.10 | Facility | 52 · Reduced service | $54.95 | $58.88 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $17.78 Typical High $19.05 | Facility | 55 · Aftercare only | $16.22 | $17.78 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $12.59 | Facility | 56 · Pre-op care only | $10.96 | $11.75 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $48.98 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.00 | $10.96 | $12.59 |
Where California sits
The same service costs 2.1 times more in Wisconsin 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· 24th of 51
$129
WI $209OH $100
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.