How much rates vary
Facilitymedian $107 · 10th to 90th $68 to $209Professionalmedian $78 · 10th to 90th $60 to $102
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 $60.26 Median $60.26 Typical High $165.96 | Facility | None | $60.26 | $60.26 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $83.18 | Professional | None | $60.26 | $60.26 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $257.04 | Facility | None | $79.43 | $114.82 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | None | $79.43 | $79.43 | $114.82 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $190.55 | Facility | None | $74.13 | $107.15 | $190.55 |
Blue Shield Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | None | $60.26 | $60.26 | $77.62 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $109.65 Typical High $151.36 | Facility | None | $60.26 | $109.65 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $97.72 | Professional | None | $72.44 | $89.13 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $158.49 | Professional | None | $60.26 | $77.62 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $173.78 | Professional | None | $120.23 | $138.04 | $173.78 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $112.20 Typical High $162.18 | Facility | None | $60.26 | $112.20 | $162.18 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $398.11 | Facility | None | $60.26 | $60.26 | $398.11 |
United Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $134.90 | Professional | None | $77.62 | $81.28 | $134.90 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.91 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Where California sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 14th of 51
$77.62
HI $158CO $60.26
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.