How much rates vary
Facilitymedian $68 · 10th to 90th $51 to $110Professionalmedian $60 · 10th to 90th $44 to $105
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 $46.77 Median $53.70 Typical High $69.18 | Facility | None | $46.77 | $53.70 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $93.33 | Professional | None | $43.65 | $60.26 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | None | $53.70 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $70.79 Typical High $295.12 | Facility | None | $56.23 | $70.79 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $79.43 | Professional | None | $56.23 | $66.07 | $79.43 |
Blue Shield Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $63.10 | Professional | None | $37.15 | $52.48 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $83.18 | Professional | None | $46.77 | $58.88 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $117.49 | Professional | None | $42.66 | $67.61 | $117.49 |
Lucent Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $33.11 Typical High $89.13 | Professional | None | $28.18 | $33.11 | $89.13 |
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 $48.98 Median $69.18 Typical High $97.72 | Facility | None | $48.98 | $69.18 | $97.72 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $83.18 | Professional | None | $46.77 | $58.88 | $83.18 |
United Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $93.33 | Professional | None | $38.90 | $54.95 | $93.33 |
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 $23.44 Median $26.92 Typical High $34.67 | Facility | 52 · Reduced service | $23.44 | $26.92 | $34.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.94 Typical High $10.47 | Facility | 55 · Aftercare only | $7.08 | $7.94 | $10.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.37 Typical High $6.92 | Facility | 56 · Pre-op care only | $4.68 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $26.92 Typical High $32.36 | Professional | 52 · Reduced service | $22.91 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.94 Typical High $9.55 | Professional | 55 · Aftercare only | $6.92 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.37 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.68 | $5.37 | $6.46 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 25 · Same-day visit | $54.95 | $54.95 | $54.95 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 93 · Audio-only telehealth | $30.20 | $30.20 | $30.20 |
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· 31st of 51
$60.26
AK $126DC $46.77
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.