How much rates vary
Facilitymedian $39 · 10th to 90th $22 to $71Professionalmedian $22 · 10th to 90th $22 to $58
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 $21.88 Median $27.54 Typical High $57.54 | Facility | None | $21.88 | $27.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $24.55 Median $38.90 Typical High $81.28 | Facility | None | $24.55 | $38.90 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $28.18 | Professional | None | $22.39 | $22.39 | $28.18 |
Blue Shield Setting Facility Modifier None Typical Low $22.39 Median $26.30 Typical High $56.23 | Facility | None | $22.39 | $26.30 | $56.23 |
Blue Shield Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $29.51 | Professional | None | $23.99 | $23.99 | $29.51 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $33.11 | Professional | None | $21.88 | $33.11 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $44.67 Typical High $67.61 | Facility | None | $22.39 | $44.67 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | None | $21.88 | $21.88 | $26.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $89.13 | Professional | None | $36.31 | $52.48 | $89.13 |
Lucent Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Providence Setting Facility Modifier None Typical Low $22.39 Median $31.62 Typical High $60.26 | Facility | None | $22.39 | $31.62 | $60.26 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Sutter Health Plus Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $74.13 | Facility | None | $23.44 | $23.44 | $74.13 |
United Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $26.92 | Professional | None | $21.88 | $23.44 | $26.92 |
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 $10.96 Median $13.80 Typical High $28.84 | Facility | 52 · Reduced service | $10.96 | $13.80 | $28.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.37 Median $5.50 Typical High $11.48 | Facility | 53 · Discontinued | $4.37 | $5.50 | $11.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.31 Median $4.07 Typical High $8.51 | Facility | 55 · Aftercare only | $3.31 | $4.07 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.75 Typical High $5.75 | Facility | 56 · Pre-op care only | $2.19 | $2.75 | $5.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
Where California sits
The same service costs 1.5 times more in Alaska than in Arizona. 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· 36th of 51
$22.39
AK $33.11AZ $21.88
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.