How much rates vary
Facilitymedian $78 · 10th to 90th $59 to $141Professionalmedian $81 · 10th to 90th $52 to $151
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 $48.98 Median $69.18 Typical High $91.20 | Facility | None | $48.98 | $69.18 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $131.83 | Professional | None | $48.98 | $77.62 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | None | $87.10 | $95.50 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $302.00 | Facility | None | $58.88 | $74.13 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $100.00 | Professional | None | $58.88 | $89.13 | $100.00 |
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 $72.44 Median $104.71 Typical High $120.23 | Professional | None | $72.44 | $104.71 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $120.23 | Professional | None | $52.48 | $81.28 | $120.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | None | $34.67 | $34.67 | $41.69 |
HealthNet Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $380.19 | Professional | None | $141.25 | $173.78 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $181.97 | Professional | None | $58.88 | $107.15 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $83.18 Typical High $724.44 | Professional | None | $33.11 | $83.18 | $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 $61.66 Median $83.18 Typical High $141.25 | Facility | None | $61.66 | $83.18 | $141.25 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $117.49 | Professional | None | $52.48 | $81.28 | $117.49 |
United Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $141.25 | Professional | None | $52.48 | $75.86 | $141.25 |
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 $24.55 Median $27.54 Typical High $45.71 | Facility | 52 · Reduced service | $24.55 | $27.54 | $45.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.24 Median $8.32 Typical High $13.80 | Facility | 55 · Aftercare only | $7.24 | $8.32 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.62 Typical High $9.12 | Facility | 56 · Pre-op care only | $4.90 | $5.62 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $34.67 Typical High $45.71 | Professional | 52 · Reduced service | $24.55 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.47 Typical High $13.80 | Professional | 55 · Aftercare only | $7.24 | $10.47 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.92 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.90 | $6.92 | $9.12 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | 25 · Same-day visit | $91.20 | $107.15 | $112.20 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | GC · Resident with teaching physician | $51.29 | $51.29 | $51.29 |
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· 38th of 51
$81.28
AK $186DC $64.57
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.