How much rates vary
Facilitymedian $200 · 10th to 90th $93 to $407Professionalmedian $148 · 10th to 90th $117 to $389
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 $117.49 Median $117.49 Typical High $263.03 | Facility | None | $117.49 | $117.49 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $165.96 | Professional | None | $117.49 | $128.82 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $223.87 Typical High $501.19 | Facility | None | $154.88 | $223.87 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $147.91 Typical High $398.11 | Professional | None | $43.65 | $147.91 | $398.11 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $338.84 | Facility | None | $77.62 | $165.96 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $446.68 | Professional | None | $117.49 | $144.54 | $446.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $177.83 | Professional | None | $104.71 | $128.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $295.12 | Facility | None | $123.03 | $213.80 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $331.13 | Professional | None | $104.71 | $162.18 | $331.13 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $316.23 | Facility | None | $117.49 | $190.55 | $316.23 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $229.09 | Professional | None | $117.49 | $117.49 | $229.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $676.08 | Facility | None | $117.49 | $117.49 | $676.08 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $446.68 | Professional | None | $147.91 | $147.91 | $446.68 |
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 $58.88 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $11.75 |
Where California sits
The same service costs 2.0 times more in Kansas than in Georgia. 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· 26th of 51
$148
KS $234GA $117
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.