How much rates vary
Facilitymedian $9 · 10th to 90th $7 to $17Professionalmedian $7 · 10th to 90th $7 to $17
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 $7.08 Median $7.24 Typical High $13.49 | Facility | None | $7.08 | $7.24 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.94 Typical High $12.59 | Professional | None | $7.08 | $7.94 | $12.59 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $23.44 | Professional | None | $6.92 | $7.59 | $23.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.92 Median $8.13 Typical High $10.47 | Facility | None | $6.92 | $8.13 | $10.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $6.92 Typical High $17.78 | Professional | None | $4.79 | $6.92 | $17.78 |
Blue Shield Setting Facility Modifier None Typical Low $8.91 Median $9.33 Typical High $13.18 | Facility | None | $8.91 | $9.33 | $13.18 |
Blue Shield Setting Professional Modifier None Typical Low $7.08 Median $8.71 Typical High $21.38 | Professional | None | $7.08 | $8.71 | $21.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $6.46 Median $7.76 Typical High $10.72 | Professional | None | $6.46 | $7.76 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $13.18 Typical High $17.78 | Facility | None | $7.41 | $13.18 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.46 Median $8.32 Typical High $19.05 | Professional | None | $6.46 | $8.32 | $19.05 |
Lucent Health Setting Professional Modifier None Typical Low $10.47 Median $12.59 Typical High $23.99 | Professional | None | $10.47 | $12.59 | $23.99 |
Molina Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Providence Setting Facility Modifier None Typical Low $7.08 Median $11.22 Typical High $19.05 | Facility | None | $7.08 | $11.22 | $19.05 |
Providence Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $11.22 | Professional | None | $7.08 | $7.08 | $11.22 |
Sutter Health Plus Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $24.55 | Professional | None | $6.92 | $6.92 | $24.55 |
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 $3.55 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $3.55 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.71 | $0.72 | $0.72 |
Where California sits
The same service costs 2.0 times more in Alaska than in Maryland. 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· 18th of 51
$7.94
AK $14.13MD $6.92
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.