How much rates vary
Facilitymedian $85 · 10th to 90th $65 to $158Professionalmedian $93 · 10th to 90th $60 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 $56.23 Median $83.18 Typical High $109.65 | Facility | None | $56.23 | $83.18 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $91.20 Typical High $154.88 | Professional | None | $56.23 | $91.20 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $125.89 | Professional | None | $102.33 | $120.23 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $85.11 Typical High $354.81 | Facility | None | $67.61 | $85.11 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $117.49 | Professional | None | $69.18 | $100.00 | $117.49 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $89.13 | Facility | None | $64.57 | $83.18 | $89.13 |
Blue Shield Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $134.90 | Professional | None | $81.28 | $114.82 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $134.90 | Professional | None | $61.66 | $97.72 | $134.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | None | $45.71 | $45.71 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $120.23 Typical High $199.53 | Professional | None | $64.57 | $120.23 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $724.44 | Professional | None | $33.11 | $107.15 | $724.44 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $97.72 Typical High $158.49 | Facility | None | $67.61 | $97.72 | $158.49 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $131.83 | Professional | None | $61.66 | $97.72 | $131.83 |
United Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $154.88 | Professional | None | $57.54 | $87.10 | $154.88 |
7 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 $28.18 Median $32.36 Typical High $54.95 | Facility | 52 · Reduced service | $28.18 | $32.36 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $9.77 Typical High $16.22 | Facility | 55 · Aftercare only | $8.51 | $9.77 | $16.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.46 Typical High $10.96 | Facility | 56 · Pre-op care only | $5.62 | $6.46 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $28.18 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.30 Typical High $16.22 | Professional | 55 · Aftercare only | $8.51 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.62 | $8.32 | $10.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $107.15 Typical High $125.89 | Professional | 25 · Same-day visit | $102.33 | $107.15 | $125.89 |
Where California sits
The same service costs 2.9 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· 37th of 51
$93.33
AK $204DC $70.79
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.