How much rates vary
Facilitymedian $324 · 10th to 90th $81 to $851Professionalmedian $324 · 10th to 90th $309 to $676
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 $309.03 Median $478.63 Typical High $812.83 | Facility | None | $309.03 | $478.63 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | None | $309.03 | $309.03 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $426.58 Typical High $1,096.48 | Facility | None | $316.23 | $426.58 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $302.00 Typical High $489.78 | Facility | None | $75.86 | $302.00 | $489.78 |
Blue Shield Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | None | $331.13 | $331.13 | $398.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $478.63 | Professional | None | $323.59 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $977.24 | Facility | None | $323.59 | $645.65 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $389.05 | Professional | None | $323.59 | $323.59 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $199.53 Median $436.52 Typical High $851.14 | Facility | None | $199.53 | $436.52 | $851.14 |
Providence Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
United Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $389.05 | Professional | None | $309.03 | $323.59 | $389.05 |
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 $154.88 Median $239.88 Typical High $398.11 | Facility | 52 · Reduced service | $154.88 | $239.88 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $95.50 Typical High $162.18 | Facility | 53 · Discontinued | $61.66 | $95.50 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $72.44 Typical High $120.23 | Facility | 55 · Aftercare only | $46.77 | $72.44 | $120.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $47.86 Typical High $81.28 | Facility | 56 · Pre-op care only | $30.90 | $47.86 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $30.90 |
Where California sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 28th of 51
$324
AK $468MT $204
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.