How much rates vary
Facilitymedian $60 · 10th to 90th $33 to $112Professionalmedian $42 · 10th to 90th $30 to $229
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 $42.66 Median $66.07 Typical High $109.65 | Facility | None | $42.66 | $66.07 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $53.70 Typical High $138.04 | Facility | None | $40.74 | $53.70 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | None | $40.74 | $40.74 | $42.66 |
Blue Shield Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $338.84 | Facility | None | $102.33 | $102.33 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | None | $41.69 | $41.69 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $60.26 Typical High $91.20 | Facility | None | $30.20 | $60.26 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $407.38 | Professional | None | $104.71 | $128.82 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | None | $229.09 | $309.03 | $309.03 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $30.20 Median $60.26 Typical High $91.20 | Facility | None | $30.20 | $60.26 | $91.20 |
Providence Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | None | $40.74 | $40.74 | $48.98 |
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 $21.38 Median $33.11 Typical High $54.95 | Facility | 52 · Reduced service | $21.38 | $33.11 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $13.18 Typical High $21.88 | Facility | 53 · Discontinued | $8.51 | $13.18 | $21.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $10.00 Typical High $16.60 | Facility | 55 · Aftercare only | $6.31 | $10.00 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.61 Typical High $10.96 | Facility | 56 · Pre-op care only | $4.27 | $6.61 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where California sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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· 19th of 51
$41.69
AK $60.26NM $30.20
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.