How much rates vary
Facilitymedian $60 · 10th to 90th $50 to $145Professionalmedian $52 · 10th to 90th $50 to $71
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 $48.98 Median $75.86 Typical High $128.82 | Facility | None | $48.98 | $75.86 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $69.18 Typical High $177.83 | Facility | None | $50.12 | $69.18 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $63.10 | Professional | None | $50.12 | $50.12 | $63.10 |
Blue Shield Setting Facility Modifier None Typical Low $50.12 Median $54.95 Typical High $131.83 | Facility | None | $50.12 | $54.95 | $131.83 |
Blue Shield Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $64.57 | Professional | None | $52.48 | $52.48 | $64.57 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $77.62 | Professional | None | $52.48 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $104.71 Typical High $158.49 | Facility | None | $52.48 | $104.71 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Contra Costa Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | None | $56.23 | $56.23 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $181.97 | Professional | None | $75.86 | $109.65 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $70.79 Typical High $138.04 | Facility | None | $51.29 | $70.79 | $138.04 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
United Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
United Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
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 $24.55 Median $38.02 Typical High $63.10 | Facility | 52 · Reduced service | $24.55 | $38.02 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.77 Median $15.14 Typical High $25.70 | Facility | 53 · Discontinued | $9.77 | $15.14 | $25.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.41 Median $11.48 Typical High $19.05 | Facility | 55 · Aftercare only | $7.41 | $11.48 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.59 Typical High $12.88 | Facility | 56 · Pre-op care only | $4.90 | $7.59 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $4.90 |
Where California sits
The same service costs 1.6 times more in Alaska than in Pennsylvania. 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· 20th of 51
$52.48
AK $79.43PA $50.12
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.