How much rates vary
Facilitymedian $40 · 10th to 90th $25 to $60Professionalmedian $25 · 10th to 90th $17 to $35
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 $25.12 Median $25.70 Typical High $43.65 | Facility | None | $25.12 | $25.70 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $37.15 | Professional | None | $25.12 | $26.30 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $17.38 Median $26.92 Typical High $37.15 | Facility | None | $17.38 | $26.92 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $26.30 | Professional | None | $17.38 | $17.38 | $26.30 |
Blue Shield Setting Facility Modifier None Typical Low $32.36 Median $39.81 Typical High $56.23 | Facility | None | $32.36 | $39.81 | $56.23 |
Blue Shield Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $31.62 | Professional | None | $25.12 | $25.12 | $31.62 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $25.12 Median $27.54 Typical High $27.54 | Professional | None | $25.12 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $45.71 Typical High $61.66 | Facility | None | $25.12 | $45.71 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $28.84 | Professional | None | $21.38 | $23.44 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.85 Median $19.05 Typical High $38.90 | Professional | None | $15.85 | $19.05 | $38.90 |
Lucent Health Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $42.66 | Professional | None | $23.99 | $30.90 | $42.66 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
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 $25.12 Median $44.67 Typical High $69.18 | Facility | None | $25.12 | $44.67 | $69.18 |
Providence Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $30.90 | Professional | None | $16.60 | $17.78 | $30.90 |
9 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 Facility Modifier 52 · Reduced service Typical Low $12.30 Median $12.88 Typical High $21.88 | Facility | 52 · Reduced service | $12.30 | $12.88 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.01 Median $5.13 Typical High $8.71 | Facility | 53 · Discontinued | $5.01 | $5.13 | $8.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.72 Median $3.89 Typical High $6.61 | Facility | 55 · Aftercare only | $3.72 | $3.89 | $6.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.57 Typical High $4.37 | Facility | 56 · Pre-op care only | $2.45 | $2.57 | $4.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.72 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.51 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $16.60 Median $25.12 Typical High $25.12 | Professional | JZ · No drug discarded | $16.60 | $25.12 | $25.12 |
Where California sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 20th of 51
$25.12
WY $39.81AZ $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.