How much rates vary
Facilitymedian $16 · 10th to 90th $9 to $42Professionalmedian $9 · 10th to 90th $8 to $13
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 $8.13 Median $12.30 Typical High $22.91 | Facility | None | $8.13 | $12.30 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.71 Typical High $10.72 | Professional | None | $8.13 | $8.71 | $10.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.33 Median $14.79 Typical High $30.20 | Facility | None | $9.33 | $14.79 | $30.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $14.45 | Professional | None | $9.12 | $9.12 | $14.45 |
Blue Shield Setting Facility Modifier None Typical Low $11.48 Median $35.48 Typical High $53.70 | Facility | None | $11.48 | $35.48 | $53.70 |
Blue Shield Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $10.96 | Professional | None | $8.91 | $8.91 | $10.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $8.91 | Professional | None | $8.13 | $8.91 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $15.14 Typical High $20.42 | Facility | None | $8.13 | $15.14 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.41 Median $10.72 Typical High $11.75 | Professional | None | $7.41 | $10.72 | $11.75 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $8.71 Typical High $18.62 | Professional | None | $7.76 | $8.71 | $18.62 |
Lucent Health Setting Professional Modifier None Typical Low $11.22 Median $27.54 Typical High $35.48 | Professional | None | $11.22 | $27.54 | $35.48 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
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 $8.32 Median $15.49 Typical High $24.55 | Facility | None | $8.32 | $15.49 | $24.55 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
United Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $63.10 | Facility | None | $8.13 | $8.13 | $63.10 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $16.60 | Professional | None | $8.71 | $9.33 | $16.60 |
8 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 $4.07 Median $6.76 Typical High $11.48 | Facility | 52 · Reduced service | $4.07 | $6.76 | $11.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.62 Median $2.69 Typical High $4.57 | Facility | 53 · Discontinued | $1.62 | $2.69 | $4.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.23 Median $2.04 Typical High $3.47 | Facility | 55 · Aftercare only | $1.23 | $2.04 | $3.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.35 Typical High $2.29 | Facility | 56 · Pre-op care only | $0.81 | $1.35 | $2.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.17 Typical High $4.17 | Professional | 52 · Reduced service | $4.07 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.66 Typical High $1.66 | Professional | 53 · Discontinued | $1.62 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.83 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.83 | $0.83 |
Where California sits
The same service costs 1.9 times more in Wyoming 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· 17th of 51
$8.91
WY $15.49GA $8.13
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.