How much rates vary
Facilitymedian $35 · 10th to 90th $22 to $66Professionalmedian $22 · 10th to 90th $21 to $50
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 $21.38 Median $21.88 Typical High $38.02 | Facility | None | $21.38 | $21.88 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $32.36 | Professional | None | $21.38 | $23.99 | $32.36 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $36.31 Typical High $74.13 | Facility | None | $23.44 | $36.31 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $20.89 Typical High $52.48 | Professional | None | $17.38 | $20.89 | $52.48 |
Blue Shield Setting Facility Modifier None Typical Low $26.92 Median $34.67 Typical High $54.95 | Facility | None | $26.92 | $34.67 | $54.95 |
Blue Shield Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $61.66 | Professional | None | $21.88 | $26.92 | $61.66 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $19.50 Median $23.99 Typical High $32.36 | Professional | None | $19.50 | $23.99 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $39.81 Typical High $53.70 | Facility | None | $22.39 | $39.81 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.50 Median $25.12 Typical High $57.54 | Professional | None | $19.50 | $25.12 | $57.54 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $38.90 Typical High $60.26 | Facility | None | $21.38 | $38.90 | $60.26 |
Providence Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $34.67 | Professional | None | $21.38 | $21.38 | $34.67 |
Sutter Health Plus Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $67.61 | Facility | None | $21.38 | $21.38 | $67.61 |
United Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $81.28 | Professional | None | $20.89 | $20.89 | $81.28 |
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 $10.72 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.24 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.14 | $2.19 | $2.19 |
Where California sits
The same service costs 1.9 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· 8th of 51
$25.12
AK $39.81MD $20.89
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.