How much rates vary
Facilitymedian $6 · 10th to 90th $3 to $10Professionalmedian $3 · 10th to 90th $3 to $4
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 $2.88 Median $4.57 Typical High $8.13 | Facility | None | $2.88 | $4.57 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $3.02 Typical High $4.37 | Professional | None | $2.88 | $3.02 | $4.37 |
Ambetter Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.09 Median $3.80 Typical High $4.27 | Facility | None | $3.09 | $3.80 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.90 | Professional | None | $3.39 | $3.39 | $4.90 |
Blue Shield Setting Facility Modifier None Typical Low $3.80 Median $8.91 Typical High $11.48 | Facility | None | $3.80 | $8.91 | $11.48 |
Blue Shield Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.72 | Professional | None | $3.02 | $3.02 | $3.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.88 Median $3.16 Typical High $3.16 | Professional | None | $2.88 | $3.16 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $5.25 Typical High $7.24 | Facility | None | $2.88 | $5.25 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $4.27 | Professional | None | $3.16 | $3.47 | $4.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.88 Median $3.24 Typical High $6.03 | Professional | None | $2.88 | $3.24 | $6.03 |
Lucent Health Setting Professional Modifier None Typical Low $3.39 Median $4.79 Typical High $10.00 | Professional | None | $3.39 | $4.79 | $10.00 |
Molina Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Providence Setting Facility Modifier None Typical Low $2.88 Median $5.13 Typical High $7.94 | Facility | None | $2.88 | $5.13 | $7.94 |
Providence Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
United Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $3.89 | Professional | None | $3.24 | $3.47 | $3.89 |
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 $1.45 Median $2.51 Typical High $4.27 | Facility | 52 · Reduced service | $1.45 | $2.51 | $4.27 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.58 Median $1.00 Typical High $1.70 | Facility | 53 · Discontinued | $0.58 | $1.00 | $1.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.43 Median $0.76 Typical High $1.29 | Facility | 55 · Aftercare only | $0.43 | $0.76 | $1.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.51 Typical High $0.85 | Facility | 56 · Pre-op care only | $0.28 | $0.51 | $0.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.44 Typical High $0.44 | Professional | 55 · Aftercare only | $0.43 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | JZ · No drug discarded | $3.24 | $3.24 | $3.24 |
Where California sits
The same service costs 3.1 times more in Wyoming than in Delaware. 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· 10th of 51
$3.24
WY $8.91DE $2.88
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.