How much rates vary
Facilitymedian $35 · 10th to 90th $25 to $62Professionalmedian $34 · 10th to 90th $22 to $62
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 $22.91 Median $26.30 Typical High $41.69 | Facility | None | $22.91 | $26.30 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $54.95 | Professional | None | $22.91 | $33.88 | $54.95 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $44.67 | Professional | None | $33.11 | $37.15 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $27.54 Median $34.67 Typical High $141.25 | Facility | None | $27.54 | $34.67 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $45.71 | Professional | None | $27.54 | $35.48 | $45.71 |
Blue Shield Setting Professional Modifier None Typical Low $21.38 Median $30.90 Typical High $37.15 | Professional | None | $21.38 | $30.90 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $34.67 Typical High $50.12 | Professional | None | $22.91 | $34.67 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $41.69 Typical High $67.61 | Professional | None | $20.89 | $41.69 | $67.61 |
Lucent Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $53.70 | Professional | None | $32.36 | $33.11 | $53.70 |
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 $23.99 Median $38.02 Typical High $60.26 | Facility | None | $23.99 | $38.02 | $60.26 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $48.98 | Professional | None | $22.91 | $33.88 | $48.98 |
United Setting Professional Modifier None Typical Low $19.05 Median $31.62 Typical High $56.23 | Professional | None | $19.05 | $31.62 | $56.23 |
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 $11.48 Median $13.18 Typical High $20.89 | Facility | 52 · Reduced service | $11.48 | $13.18 | $20.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.47 Median $3.98 Typical High $6.31 | Facility | 55 · Aftercare only | $3.47 | $3.98 | $6.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.63 Typical High $4.17 | Facility | 56 · Pre-op care only | $2.29 | $2.63 | $4.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $14.45 Typical High $19.05 | Professional | 52 · Reduced service | $11.48 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $4.37 Typical High $5.75 | Professional | 55 · Aftercare only | $3.47 | $4.37 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.95 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.29 | $2.95 | $3.89 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | 25 · Same-day visit | $33.88 | $33.88 | $44.67 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 93 · Audio-only telehealth | $15.14 | $15.14 | $15.14 |
Where California sits
The same service costs 2.8 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· 30th of 51
$33.88
AK $66.07DC $23.99
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.