How much rates vary
Facilitymedian $55 · 10th to 90th $40 to $107Professionalmedian $40 · 10th to 90th $38 to $48
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 $38.02 Median $61.66 Typical High $104.71 | Facility | None | $38.02 | $61.66 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | None | $38.02 | $38.90 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $56.23 | Facility | None | $40.74 | $46.77 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Blue Shield Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $154.88 | Facility | None | $51.29 | $53.70 | $154.88 |
Blue Shield Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | None | $38.02 | $38.02 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $69.18 Typical High $95.50 | Facility | None | $38.02 | $69.18 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $47.86 | Professional | None | $36.31 | $40.74 | $47.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $74.13 | Professional | None | $35.48 | $39.81 | $74.13 |
Lucent Health Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $74.13 | Professional | None | $42.66 | $52.48 | $74.13 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $38.90 Median $72.44 Typical High $114.82 | Facility | None | $38.90 | $72.44 | $114.82 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $47.86 | Professional | None | $39.81 | $41.69 | $47.86 |
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 $19.05 Median $30.90 Typical High $52.48 | Facility | 52 · Reduced service | $19.05 | $30.90 | $52.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $12.30 Typical High $20.89 | Facility | 53 · Discontinued | $7.59 | $12.30 | $20.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $9.33 Typical High $15.85 | Facility | 55 · Aftercare only | $5.75 | $9.33 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.17 Typical High $10.47 | Facility | 56 · Pre-op care only | $3.80 | $6.17 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 53 · Discontinued | $7.59 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.80 | $3.89 | $3.89 |
Where California sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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
$39.81
AK $60.26SC $38.02
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.