How much rates vary
Facilitymedian $71 · 10th to 90th $43 to $126Professionalmedian $44 · 10th to 90th $43 to $59
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 $43.65 Median $58.88 Typical High $107.15 | Facility | None | $43.65 | $58.88 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $66.07 | Professional | None | $43.65 | $47.86 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $151.36 | Facility | None | $47.86 | $72.44 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | None | $43.65 | $43.65 | $57.54 |
Blue Shield Setting Facility Modifier None Typical Low $40.74 Median $44.67 Typical High $89.13 | Facility | None | $40.74 | $44.67 | $89.13 |
Blue Shield Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $54.95 | Professional | None | $44.67 | $44.67 | $54.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $47.86 | Professional | None | $43.65 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $79.43 Typical High $109.65 | Facility | None | $43.65 | $79.43 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $50.12 | Professional | None | $41.69 | $42.66 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $75.86 | Professional | None | $38.90 | $42.66 | $75.86 |
Lucent Health Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $77.62 | Professional | None | $45.71 | $47.86 | $77.62 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $79.43 Typical High $120.23 | Facility | None | $43.65 | $79.43 | $120.23 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Sutter Health Plus Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $109.65 | Facility | None | $43.65 | $43.65 | $109.65 |
United Setting Professional Modifier None Typical Low $38.02 Median $42.66 Typical High $50.12 | Professional | None | $38.02 | $42.66 | $50.12 |
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 $21.88 Median $33.11 Typical High $54.95 | Facility | 52 · Reduced service | $21.88 | $33.11 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $13.18 Typical High $22.39 | Facility | 53 · Discontinued | $8.71 | $13.18 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $9.77 Typical High $16.60 | Facility | 55 · Aftercare only | $6.61 | $9.77 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.61 Typical High $11.22 | Facility | 56 · Pre-op care only | $4.37 | $6.61 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Ambetter Setting Professional Modifier JW · Drug discarded + KP · First drug of several + KQ · Later drug of several Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | JW · Drug discarded + KP · First drug of several + KQ · Later drug of several | $48.98 | $48.98 | $48.98 |
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· 41st of 51
$43.65
AK $54.95OR $43.65
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.