How much rates vary
Facilitymedian $93 · 10th to 90th $74 to $174Professionalmedian $100 · 10th to 90th $71 to $178
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 $64.57 Median $93.33 Typical High $109.65 | Facility | None | $64.57 | $93.33 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $165.96 | Professional | None | $64.57 | $93.33 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $134.90 | Professional | None | $66.07 | $120.23 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $407.38 | Facility | None | $77.62 | $97.72 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $123.03 | Professional | None | $77.62 | $107.15 | $123.03 |
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 $87.10 Median $123.03 Typical High $141.25 | Professional | None | $87.10 | $123.03 | $141.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $165.96 | Professional | None | $93.33 | $123.03 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $147.91 | Professional | None | $70.79 | $97.72 | $147.91 |
Contra Costa Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | None | $102.33 | $102.33 | $123.03 |
HealthNet Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $630.96 | Professional | None | $186.21 | $204.17 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $223.87 | Professional | None | $75.86 | $125.89 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $281.84 Median $724.44 Typical High $724.44 | Professional | None | $281.84 | $724.44 | $724.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $100.00 Typical High $165.96 | Professional | None | $33.11 | $100.00 | $165.96 |
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 $77.62 Median $109.65 Typical High $173.78 | Facility | None | $77.62 | $109.65 | $173.78 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $144.54 | Professional | None | $70.79 | $97.72 | $144.54 |
United Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $169.82 | Professional | None | $66.07 | $91.20 | $169.82 |
9 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 $32.36 Median $37.15 Typical High $54.95 | Facility | 52 · Reduced service | $32.36 | $37.15 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $16.60 | Facility | 55 · Aftercare only | $9.77 | $11.22 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.41 Typical High $10.96 | Facility | 56 · Pre-op care only | $6.46 | $7.41 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $42.66 Typical High $54.95 | Professional | 52 · Reduced service | $32.36 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.51 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.46 | $8.51 | $10.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $120.23 Typical High $134.90 | Professional | 25 · Same-day visit | $107.15 | $120.23 | $134.90 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 33 · Preventive service | $120.23 | $120.23 | $120.23 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $117.49 Median $158.49 Typical High $158.49 | Professional | SA · Nurse practitioner | $117.49 | $158.49 | $158.49 |
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· 37th of 51
$100
AK $224DC $83.18
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.