How much rates vary
Facilitymedian $20 · 10th to 90th $15 to $47Professionalmedian $17 · 10th to 90th $14 to $135
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 $15.85 Median $20.42 Typical High $27.54 | Facility | None | $15.85 | $20.42 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $25.12 | Professional | None | $15.85 | $18.62 | $25.12 |
Ambetter Setting Professional Modifier None Typical Low $15.49 Median $15.85 Typical High $28.18 | Professional | None | $15.49 | $15.85 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $18.20 Typical High $75.86 | Facility | None | $14.45 | $18.20 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $25.70 | Professional | None | $14.79 | $14.79 | $25.70 |
Blue Shield Setting Facility Modifier None Typical Low $21.38 Median $36.31 Typical High $53.70 | Facility | None | $21.38 | $36.31 | $53.70 |
Blue Shield Setting Professional Modifier None Typical Low $14.45 Median $20.42 Typical High $28.18 | Professional | None | $14.45 | $20.42 | $28.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $18.20 Median $21.88 Typical High $21.88 | Professional | None | $18.20 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.30 Median $19.50 Typical High $21.38 | Professional | None | $12.30 | $19.50 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.49 Median $17.78 Typical High $33.11 | Professional | None | $15.49 | $17.78 | $33.11 |
Lucent Health Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | None | $134.90 | $169.82 | $169.82 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
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 $17.38 Median $20.89 Typical High $28.84 | Facility | None | $17.38 | $20.89 | $28.84 |
Providence Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $51.29 | Professional | None | $9.77 | $9.77 | $51.29 |
United Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
United Setting Professional Modifier None Typical Low $11.48 Median $15.49 Typical High $25.12 | Professional | None | $11.48 | $15.49 | $25.12 |
4 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 Professional Modifier 52 · Reduced service Typical Low $6.61 Median $8.51 Typical High $10.23 | Professional | 52 · Reduced service | $6.61 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.39 Typical High $4.07 | Professional | 53 · Discontinued | $2.63 | $3.39 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.51 Typical High $3.09 | Professional | 55 · Aftercare only | $2.00 | $2.51 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.70 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.32 | $1.70 | $2.04 |
Where California sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 25th of 51
$16.98
AK $38.90LA $13.80
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.