How much rates vary
Facilitymedian $56 · 10th to 90th $29 to $87Professionalmedian $29 · 10th to 90th $25 to $36
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 $28.84 Median $38.90 Typical High $64.57 | Facility | None | $28.84 | $38.90 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $38.02 Typical High $83.18 | Facility | None | $26.92 | $38.02 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $45.71 | Professional | None | $25.70 | $25.70 | $45.71 |
Blue Shield Setting Facility Modifier None Typical Low $30.90 Median $67.61 Typical High $95.50 | Facility | None | $30.90 | $67.61 | $95.50 |
Blue Shield Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $36.31 | Professional | None | $28.84 | $28.84 | $36.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | None | $28.84 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $52.48 Typical High $72.44 | Facility | None | $28.84 | $52.48 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.88 Median $23.99 Typical High $29.51 | Professional | None | $21.88 | $23.99 | $29.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.44 Median $25.70 Typical High $54.95 | Professional | None | $23.44 | $25.70 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $22.91 Median $56.23 Typical High $67.61 | Professional | None | $22.91 | $56.23 | $67.61 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
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 $28.84 Median $50.12 Typical High $79.43 | Facility | None | $28.84 | $50.12 | $79.43 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $24.55 Median $26.30 Typical High $37.15 | Professional | None | $24.55 | $26.30 | $37.15 |
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 $14.45 Median $19.50 Typical High $32.36 | Facility | 52 · Reduced service | $14.45 | $19.50 | $32.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $7.76 Typical High $12.88 | Facility | 53 · Discontinued | $5.75 | $7.76 | $12.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.37 Median $5.75 Typical High $9.77 | Facility | 55 · Aftercare only | $4.37 | $5.75 | $9.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.89 Typical High $6.46 | Facility | 56 · Pre-op care only | $2.88 | $3.89 | $6.46 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Where California sits
The same service costs 2.8 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· 27th of 51
$28.84
WY $67.61AZ $24.55
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.