How much rates vary
Facilitymedian $117 · 10th to 90th $74 to $219Professionalmedian $74 · 10th to 90th $71 to $98
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 $70.79 Median $102.33 Typical High $194.98 | Facility | None | $70.79 | $102.33 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $104.71 | Professional | None | $70.79 | $74.13 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $263.03 | Facility | None | $79.43 | $123.03 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | None | $75.86 | $75.86 | $104.71 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $173.78 | Facility | None | $75.86 | $100.00 | $173.78 |
Blue Shield Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $89.13 | Professional | None | $70.79 | $70.79 | $89.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | None | $70.79 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $128.82 Typical High $173.78 | Facility | None | $70.79 | $128.82 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $89.13 | Professional | None | $74.13 | $75.86 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $141.25 | Professional | None | $66.07 | $74.13 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $134.90 | Professional | None | $87.10 | $109.65 | $134.90 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $70.79 Median $123.03 Typical High $186.21 | Facility | None | $70.79 | $123.03 | $186.21 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Sutter Health Plus Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $354.81 | Facility | None | $70.79 | $70.79 | $354.81 |
United Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $87.10 | Professional | None | $74.13 | $77.62 | $87.10 |
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 $35.48 Median $57.54 Typical High $97.72 | Facility | 52 · Reduced service | $35.48 | $57.54 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $22.91 Typical High $38.90 | Facility | 53 · Discontinued | $14.13 | $22.91 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $17.38 Typical High $28.84 | Facility | 55 · Aftercare only | $10.47 | $17.38 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.48 Typical High $19.50 | Facility | 56 · Pre-op care only | $7.08 | $11.48 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.08 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | JW · Drug discarded | $74.13 | $74.13 | $74.13 |
Where California sits
The same service costs 1.5 times more in Wyoming than in Florida. 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· 17th of 51
$74.13
WY $107FL $70.79
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.