How much rates vary
Facilitymedian $295 · 10th to 90th $95 to $562Professionalmedian $209 · 10th to 90th $186 to $417
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 $208.93 Median $208.93 Typical High $338.84 | Facility | None | $208.93 | $208.93 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $302.00 | Professional | None | $208.93 | $218.78 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $346.74 Typical High $676.08 | Facility | None | $218.78 | $346.74 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $426.58 | Professional | None | $87.10 | $186.21 | $426.58 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $204.17 Typical High $331.13 | Facility | None | $77.62 | $204.17 | $331.13 |
Blue Shield Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $588.84 | Professional | None | $213.80 | $257.04 | $588.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $309.03 | Professional | None | $186.21 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $524.81 | Facility | None | $208.93 | $380.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $549.54 | Professional | None | $186.21 | $234.42 | $549.54 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $562.34 | Facility | None | $186.21 | $363.08 | $562.34 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $288.40 | Professional | None | $208.93 | $208.93 | $288.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $691.83 | Facility | None | $208.93 | $208.93 | $691.83 |
United Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $588.84 | Professional | None | $186.21 | $199.53 | $588.84 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Where California sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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· 16th of 51
$219
AZ $324RI $200
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.