How much rates vary
Facilitymedian $48 · 10th to 90th $32 to $93Professionalmedian $30 · 10th to 90th $29 to $126
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 $28.84 Median $36.31 Typical High $75.86 | Facility | None | $28.84 | $36.31 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.11 Median $53.70 Typical High $97.72 | Facility | None | $33.11 | $53.70 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $39.81 | Professional | None | $29.51 | $29.51 | $39.81 |
Blue Shield Setting Facility Modifier None Typical Low $32.36 Median $34.67 Typical High $70.79 | Facility | None | $32.36 | $34.67 | $70.79 |
Blue Shield Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $35.48 | Professional | None | $28.84 | $28.84 | $35.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.84 Median $42.66 Typical High $42.66 | Professional | None | $28.84 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $64.57 Typical High $97.72 | Facility | None | $32.36 | $64.57 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Contra Costa Health Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $33.88 | Professional | None | $28.84 | $31.62 | $33.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.70 Median $28.84 Typical High $43.65 | Professional | None | $25.70 | $28.84 | $43.65 |
Lucent Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | None | $125.89 | $169.82 | $169.82 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $41.69 Typical High $87.10 | Facility | None | $28.84 | $41.69 | $87.10 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $34.67 | Professional | None | $28.84 | $30.20 | $34.67 |
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 $14.13 Median $18.20 Typical High $37.15 | Facility | 52 · Reduced service | $14.13 | $18.20 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $7.24 Typical High $15.14 | Facility | 53 · Discontinued | $5.75 | $7.24 | $15.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $5.37 Typical High $11.22 | Facility | 55 · Aftercare only | $4.27 | $5.37 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.63 Typical High $7.59 | Facility | 56 · Pre-op care only | $2.82 | $3.63 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.13 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.27 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.82 | $2.88 | $2.88 |
Where California sits
Rates are fairly even across states for this service. 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
$30.20
AK $42.66MD $28.84
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.