How much rates vary
Facilitymedian $36 · 10th to 90th $30 to $72Professionalmedian $31 · 10th to 90th $30 to $32
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 $30.20 Median $46.77 Typical High $77.62 | Facility | None | $30.20 | $46.77 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $35.48 Typical High $44.67 | Facility | None | $30.90 | $35.48 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Blue Shield Setting Facility Modifier None Typical Low $26.92 Median $30.90 Typical High $44.67 | Facility | None | $26.92 | $30.90 | $44.67 |
Blue Shield Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | None | $30.20 | $30.20 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $61.66 Typical High $93.33 | Facility | None | $30.90 | $61.66 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $281.84 | Professional | None | $104.71 | $128.82 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $38.02 | Professional | None | $25.70 | $25.70 | $38.02 |
Molina Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
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 $24.55 Median $42.66 Typical High $83.18 | Facility | None | $24.55 | $42.66 | $83.18 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | None | $30.20 | $30.20 | $35.48 |
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 $23.44 Typical High $38.90 | Facility | 52 · Reduced service | $15.14 | $23.44 | $38.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.03 Median $9.33 Typical High $15.49 | Facility | 53 · Discontinued | $6.03 | $9.33 | $15.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $7.08 Typical High $11.75 | Facility | 55 · Aftercare only | $4.47 | $7.08 | $11.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.02 Median $4.68 Typical High $7.76 | Facility | 56 · Pre-op care only | $3.02 | $4.68 | $7.76 |
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 $6.03 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.02 |
Where California sits
The same service costs 4.7 times more in Alaska than in Hawaii. 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
$30.90
AK $44.67HI $9.55
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.