How much rates vary
Facilitymedian $295 · 10th to 90th $95 to $550Professionalmedian $178 · 10th to 90th $162 to $263
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 $162.18 Median $223.87 Typical High $446.68 | Facility | None | $162.18 | $223.87 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $346.74 | Professional | None | $162.18 | $177.83 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $281.84 | Professional | None | $162.18 | $234.42 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $630.96 | Facility | None | $190.55 | $295.12 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $363.08 | Professional | None | $181.97 | $181.97 | $363.08 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $269.15 Typical High $537.03 | Facility | None | $77.62 | $269.15 | $537.03 |
Blue Shield Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $204.17 | Professional | None | $162.18 | $162.18 | $204.17 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | None | $162.18 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $295.12 Typical High $398.11 | Facility | None | $162.18 | $295.12 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $208.93 | Professional | None | $173.78 | $177.83 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $371.54 | Professional | None | $158.49 | $177.83 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $457.09 | Professional | None | $177.83 | $229.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $162.18 Median $302.00 Typical High $457.09 | Facility | None | $162.18 | $302.00 | $457.09 |
Providence Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $794.33 | Facility | None | $162.18 | $162.18 | $794.33 |
United Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $213.80 | Professional | None | $177.83 | $181.97 | $213.80 |
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 $79.43 Median $138.04 Typical High $234.42 | Facility | 52 · Reduced service | $79.43 | $138.04 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $54.95 Typical High $93.33 | Facility | 53 · Discontinued | $32.36 | $54.95 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $41.69 Typical High $69.18 | Facility | 55 · Aftercare only | $23.99 | $41.69 | $69.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $46.77 | Facility | 56 · Pre-op care only | $15.85 | $27.54 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.85 | $16.22 | $16.22 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | JZ · No drug discarded | $162.18 | $177.83 | $177.83 |
Where California sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 15th of 51
$178
WY $302NV $162
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.