How much rates vary
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 $69.18 Median $79.43 Typical High $95.50 | Facility | None | $69.18 | $79.43 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $109.65 | Professional | None | $69.18 | $83.18 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $104.71 Typical High $436.52 | Facility | None | $83.18 | $104.71 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $112.20 | Professional | None | $79.43 | $97.72 | $112.20 |
Blue Shield Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $87.10 | Professional | None | $51.29 | $74.13 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $117.49 | Professional | None | $69.18 | $85.11 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $165.96 | Professional | None | $63.10 | $95.50 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $123.03 | Professional | None | $33.11 | $42.66 | $123.03 |
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 $75.86 Median $97.72 Typical High $131.83 | Facility | None | $75.86 | $97.72 | $131.83 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $117.49 | Professional | None | $69.18 | $83.18 | $117.49 |
United Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $128.82 | Professional | None | $57.54 | $75.86 | $128.82 |
6 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 $34.67 Median $39.81 Typical High $47.86 | Facility | 52 · Reduced service | $34.67 | $39.81 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $12.02 Typical High $14.45 | Facility | 55 · Aftercare only | $10.47 | $12.02 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.94 Typical High $9.55 | Facility | 56 · Pre-op care only | $6.92 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $39.81 Typical High $44.67 | Professional | 52 · Reduced service | $33.88 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.02 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $8.91 |
Where California sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 27th of 51
$85.11
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.