How much rates vary
Facilitymedian $129 · 10th to 90th $87 to $224Professionalmedian $135 · 10th to 90th $98 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 $89.13 Median $112.20 Typical High $144.54 | Facility | None | $89.13 | $112.20 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $213.80 | Professional | None | $89.13 | $123.03 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $169.82 | Professional | None | $134.90 | $154.88 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $562.34 | Facility | None | $107.15 | $134.90 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $165.96 | Professional | None | $109.65 | $138.04 | $165.96 |
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 $112.20 Median $158.49 Typical High $186.21 | Professional | None | $112.20 | $158.49 | $186.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $213.80 | Professional | None | $123.03 | $154.88 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $199.53 | Professional | None | $97.72 | $138.04 | $199.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | None | $131.83 | $131.83 | $158.49 |
HealthNet Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $288.40 | Professional | None | $100.00 | $162.18 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $125.89 Typical High $208.93 | Professional | None | $33.11 | $125.89 | $208.93 |
Optum Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $177.83 | Professional | None | $125.89 | $158.49 | $177.83 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $223.87 | Facility | None | $104.71 | $147.91 | $223.87 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $190.55 | Professional | None | $97.72 | $134.90 | $190.55 |
United Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $218.78 | Professional | None | $89.13 | $120.23 | $218.78 |
8 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 $44.67 Median $51.29 Typical High $72.44 | Facility | 52 · Reduced service | $44.67 | $51.29 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $21.88 | Facility | 55 · Aftercare only | $13.49 | $15.49 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.23 Typical High $14.45 | Facility | 56 · Pre-op care only | $8.91 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $56.23 Typical High $72.44 | Professional | 52 · Reduced service | $44.67 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $21.88 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.22 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.91 | $11.22 | $14.45 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $134.90 Median $151.36 Typical High $169.82 | Professional | 25 · Same-day visit | $134.90 | $151.36 | $169.82 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 33 · Preventive service | $147.91 | $147.91 | $147.91 |
Where California sits
The same service costs 2.7 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· 34th of 51
$135
AK $295DC $110
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.