How much rates vary
Facilitymedian $37 · 10th to 90th $31 to $89Professionalmedian $32 · 10th to 90th $31 to $37
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 $30.90 Median $47.86 Typical High $79.43 | Facility | None | $30.90 | $47.86 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $42.66 Typical High $112.20 | Facility | None | $30.90 | $42.66 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | None | $31.62 | $31.62 | $35.48 |
Blue Shield Setting Facility Modifier None Typical Low $31.62 Median $33.88 Typical High $56.23 | Facility | None | $31.62 | $33.88 | $56.23 |
Blue Shield Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | None | $33.11 | $33.11 | $40.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $48.98 | Professional | None | $32.36 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $63.10 Typical High $95.50 | Facility | None | $31.62 | $63.10 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | None | $37.15 | $37.15 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $104.71 | Professional | None | $39.81 | $57.54 | $104.71 |
Lucent Health Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $53.70 | Professional | None | $40.74 | $48.98 | $53.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $25.12 Median $43.65 Typical High $85.11 | Facility | None | $25.12 | $43.65 | $85.11 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Sutter Health Plus Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $37.15 | Professional | None | $30.90 | $32.36 | $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 $15.14 Median $23.99 Typical High $39.81 | Facility | 52 · Reduced service | $15.14 | $23.99 | $39.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.17 Median $9.55 Typical High $15.85 | Facility | 53 · Discontinued | $6.17 | $9.55 | $15.85 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $7.08 Typical High $12.02 | Facility | 55 · Aftercare only | $4.57 | $7.08 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.79 Typical High $7.94 | Facility | 56 · Pre-op care only | $3.09 | $4.79 | $7.94 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Where California sits
Rates are fairly even across states for this service. 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· 21st of 51
$31.62
AK $45.71AZ $30.90
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.